Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN.Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN.Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta.Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072).Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB.Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.

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Colorectal Cancer Risk in Women with Gynecologic Cancers—A Population Retrospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10143127 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3127

Author(s):

Szu-Chia Liao ◽

Hong-Zen Yeh ◽

Chi-Sen Chang ◽

Wei-Chih Chen ◽

Chih-Hsin Muo ◽

...

Keyword(s):

Colorectal Cancer ◽

Ovarian Cancer ◽

Cervical Cancer ◽

Cohort Study ◽

Cancer Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Gynecologic Cancer ◽

Ovarian Cancers ◽

Increased Risk

We conducted a retrospective cohort study to evaluate the subsequent colorectal cancer (CRC) risk for women with gynecologic malignancy using insurance claims data of Taiwan. We identified patients who survived cervical cancer (N = 25,370), endometrial cancer (N = 8149) and ovarian cancer (N = 7933) newly diagnosed from 1998 to 2010, and randomly selected comparisons (N = 165,808) without cancer, matched by age and diagnosis date. By the end of 2011, the incidence and hazard ratio (HR) of CRC were estimated. We found that CRC incidence rates were 1.26-, 2.20-, and 1.61-fold higher in women with cervical, endometrial and ovarian cancers, respectively, than in comparisons (1.09/1000 person–years). The CRC incidence increased with age. Higher adjusted HRs of CRC appeared within 3 years for women with endometrial and ovarian cancers, but not until the 4th to 7th years of follow up for cervical cancer survivals. Cancer treatments could reduce CRC risks, but not significantly. However, ovarian cancer patients receiving surgery alone had an incidence of 3.33/1000 person–years for CRC with an adjusted HR of 3.79 (95% CI 1.11–12.9) compared to patients without any treatment. In conclusion, gynecologic cancer patients are at an increased risk of developing CRC, sooner for those with endometrial or ovarian cancer than those with cervical cancer.

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Effect of percutaneous nephrostomy in late stage cervical cancer’s survival with impaired renal function

Majalah Obstetri & Ginekologi ◽

10.20473/mog.v24i22016.49-52 ◽

2018 ◽

Vol 24 (2) ◽

pp. 49

Author(s):

Imam Rasjidi Mashadi ◽

Ali Gunawan ◽

Christine Susanto

Keyword(s):

Cervical Cancer ◽

Renal Function ◽

Cancer Patients ◽

Median Survival ◽

Medical Records ◽

Impaired Renal Function ◽

Percutaneous Nephrostomy ◽

Advanced Cervical Cancer ◽

Probability Of Survival ◽

Consecutive Sampling

Objective: explore the association between percutaneous nephrostomy and survival of patients with advanced cervical cancer accompanied by renal impairment.Materials and Methods: Retrospective cohort, with 70 samples taken with consecutive sampling. The population was all advanced cervical cancer patients with impaired renal function (IIIB, IVA, IVB, recurrent) treated in RSUPNCM since January 1, 1998. Sample size was each 19 patients for percutaneous nephrostomy and conservative groups. Survival was measured from medical records of advanced cervical cancer patients with impaired renal function who were treated at RSUPNCM since January 1, 1998 until December 31, 2003. Percutaneous nephrostomy was measured from medical records of advanced cervical cancer patients with impaired renal function treated at RSUPNCM since 1 January 1998 until December 31, 2003.Results: Median survival of 44 respondents who underwent percutaneous nephrostomy was 203 days with probability of survival at 6 months 56.9% and 12 months by 31.1%. Median survival of 26 respondents who did not undergo percutaneous nephrostomy was 75 days with a chance of survival at 6 months 26.6% and 12 months 10%. There were significant differences between patients undergoing percutaneous nephrostomy and those without (p = 0.0470, α = 0.05).Conclusion: There was significant association between percutaneous nephrostomy and survival (p = 0.0470, α = 0.05).

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EP238 Paraaortic lymph nodes involvement as a prognostic factor in patients with advanced cervical cancer staged by laparoscopy

10.1136/ijgc-2019-esgo.300 ◽

2019 ◽

Author(s):

N Agusti ◽

B Diaz-Feijoo ◽

N Carreras ◽

E Mension ◽

B Gil ◽

...

Keyword(s):

Cervical Cancer ◽

Prognostic Factor ◽

Lymph Nodes ◽

Advanced Cervical Cancer ◽

Paraaortic Lymph Nodes

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Laparoscopic Lymphadenectomy in Advanced Cervical Cancer: Prognostic and Therapeutic Value

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000000 ◽

2013 ◽

Vol 23 (9) ◽

pp. 1675-1683 ◽

Cited By ~ 17

Author(s):

Marta del Pino ◽

Pere Fusté ◽

Jaume Pahisa ◽

Àngels Rovirosa ◽

Maria Jose Martínez-Serrano ◽

...

Keyword(s):

Cervical Cancer ◽

Radiation Therapy ◽

Confidence Interval ◽

Lymph Nodes ◽

Locally Advanced ◽

Advanced Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Gynecology And Obstetrics ◽

Therapeutic Value ◽

Increased Risk

ObjectiveClinical benefit of surgical staging in locally advanced cervical cancer has not yet been proved. The goal of this study was to analyze the prognostic and therapeutic value of laparoscopic para-aortic lymphadenectomy with selective excision of suspicious pelvic nodes in patients with locally advanced cervical cancer.MethodsThis is a retrospective study including 109 women treated in a single institution from 2000 to 2009. The International Federation of Gynecology and Obstetrics stage was IB2 in 12 women, IIB in 58 women, and IIIB in 39 women. None had suspicious para-aortic nodes by presurgical imaging evaluation. All patients underwent extraperitoneal para-aortic laparoscopic lymphadenectomy with selective excision of enlarged pelvic nodes and received pelvic radiotherapy with concomitant chemotherapy. Extended lumboaortic radiation therapy was added to patients with metastatic para-aortic nodes. The mean ± SD follow-up time was 43.1 ± 33.7 months.ResultsMetastatic lymph nodes were identified in 23 (21.1%) of 109 patients in the para-aortic area and in 24 (53.3%) of 45 patients who underwent selective excision of pelvic nodes. Patients with nodal metastases had increased risk of mortality than those with negative nodes independently of the location (pelvic and/or para-aortic) of the metastases (hazard ratio, 4.07; 95% confidence interval, 1.36–12.16 for patients with pelvic metastases [P= 0.012]; and 3.73; 95% confidence interval, 1.38–10.09 for patients with para-aortic metastases [P= 0.010]). In the subset of women with para-aortic metastases treated by extended lumboaortic radiation therapy, neither the number of lymph nodes removed nor the number of positive nodes were associated with survival (P= 0.556 andP= 0.195, respectively).ConclusionPara-aortic and pelvic lymphadenectomy provides valuable information about mortality risk in patients with locally advanced cervical cancer.

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Vaginal douching in Zambia: a risk or benefit to women in the fight against cervical cancer: a retrospective cohort study

BMC Women s Health ◽

10.1186/s12905-019-0834-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Twaambo Euphemia Hamoonga ◽

Pawel Olowski ◽

Patrick Musonda

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Secondary Outcome ◽

Sugar Solution ◽

Cervical Lesions ◽

Vaginal Douching ◽

Increased Risk ◽

Study Participants

Abstract Background Cervical cancer was the most commonly diagnosed cancer and the leading cause of cancer related deaths in 2013 among women in Zambia. We determined factors associated with vaginal douching with any solution other than water and examined its role as a risk factor for abnormal cervical lesions among Zambian women. Methods We conducted a retrospective cohort study using data from the Cervical Cancer Prevention Program in Zambia among 11,853 women (15 years or older) who had screened for cervical cancer from 6 provinces of Zambia. Stata version 15 was used to analyze the data. Investigator led stepwise logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals for various characteristics, with vaginal douching with any solution as primary outcome and abnormal cervical lesions as secondary outcome. Results Douching with any solution other than water was practiced by 8.1% (n = 960) of the study participants. Older women (35–44 and 45 years or older) vs young women (15–24 years old) were less likely to douche with a solution (AOR 0.74; 95% CI: 0.57–0.97, p = 0.027 and AOR 0.65; 95% CI: 0.49–0.87, P = 0.004), respectively, and so were women in informal employment compared to housewives (AOR 0.72; 95% CI: 0.58–0.89, p = 0.002). Odds of douching were higher among women with secondary vs. no formal education (AOR 1.64; 95% CI: 1.15–2.35, P = 0.007), and among women who used condoms sometimes compared to those who never with their regular sexual partners (AOR 1.19; 95% CI: 1.01–1.40, PP = 0.037). About 12.2% of study participants had abnormal cervical lesions. The use of either vinegar, ginger, lemon, salt or sugar solution was associated with increased risk of abnormal cervical lesions (AOR 7.37; 95% CI: 1.43–38.00, p = 0.017) compared to using water. Conclusion We find an association between douching with a solution and a woman’s age, educational attainment, occupation and condom use. Vaginal douching with either vinegar, ginger, lemon, salt or sugar solution was associated with increased risk for abnormal cervical lesions. We recommend further research on ever vs never douching and the risk for abnormal cervical lesions.

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