Tumor Volume Predicts High-Risk Patients and Guides Initial Chemoradiotherapy for Early Cervical Cancer

We evaluated the relationship between the minimum tumor-free margin, tumor volume, and adverse pathological risk factors in early cervical cancer and explored the predictive value of these parameters for different types of risk patients to guide individualized therapeutic strategies. Patients who received the initial treatment of radical operation of cervical cancer and their postoperative pathological reports in our hospital from July 1, 2017, to June 30, 2019, were reviewed. Their minimum tumor-free margin and tumor volume were measured on preoperative magnetic resonance imaging. Student’s t-test and the receiver operating characteristic curve analysis were used for data analysis. A total of 240 patients were included. Adverse pathological risk factors were as follows: deep cervical infiltration, 95 (39.6%) cases; lymph vascular space invasion, 91 (37.9%); lymph node metastasis, 20 (8.3%); parametrial infiltration, 8 (3.3%); tumor diameter ≥4 cm, 7 (2.9%); and positive surgical margin, 1 (0.4%). According to the adverse pathological factors, there were 20 (8.3%) high-risk patients, 50 (20.8%) medium-risk patients, and 170 (70.8%) low-risk patients. The ranges of the minimum tumor-free margin and tumor volume were 0.01–13.5 mm and 105–27,990 mm3, respectively. The minimum tumor-free margin with lymph node metastasis was significantly smaller than that without (P <0.05). The tumor volume with parametrial infiltration, deep cervical infiltration, or lymph vascular space invasion was significantly greater than that without (P < 0.05). The tumor volume was significantly different among low-, medium-, and high-risk patients (P <0.05). Tumor volume was of predictive value for high-risk patients (P < 0.05). With 3,505 mm3 as the cutoff value, the sensitivity and specificity for the prediction of high-risk patients were 88.9% and 84.8%, respectively. Tumor volume can be used as a great predictor of high-risk patients (cutoff value, 3,505 mm3), which could be an indication of initial chemoradiotherapy for early cervical cancer.

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DNA ploidy in curettage specimens identifies high-risk patients and lymph node metastasis in endometrial cancer

British Journal of Cancer ◽

10.1038/bjc.2015.123 ◽

2015 ◽

Vol 112 (10) ◽

pp. 1656-1664 ◽

Cited By ~ 15

Author(s):

T S Njølstad ◽

◽

J Trovik ◽

T S Hveem ◽

M L Kjæreng ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Dna Ploidy ◽

High Risk Patients ◽

Node Metastasis ◽

Risk Patients

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Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India

The Journal of South Asian Federation of Menopause Societies ◽

10.5005/jp-journals-10032-1005 ◽

2013 ◽

Vol 1 (1) ◽

pp. 21-23

Author(s):

Rohini Rao ◽

Ragweshwar Jyoti ◽

Payal Gupta ◽

PL Sood ◽

Neelam Parasher

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Pap Smear ◽

Age Groups ◽

Himachal Pradesh ◽

High Risk Patients ◽

Perimenopausal Women ◽

Risk Patients ◽

Cancer Of The Cervix ◽

Sensitivity Specificity

ABSTRACT Objectives To determine the correlation between cytology, colposcopy and histopathology, individually and in combination, in high-risk patients for detection of early cancer of the cervix. Materials and methods A total of 200 high-risk patients in the age groups of 35 to 60 years were included in the study. Pap smear, colposcopy and colposcopically directed biopsies were taken from the suspicious area. Results Sensitivity, specificity and positive predictive value of Pap smear are 65.2, 96.3 and 89.3% respectively. Correlation between cytology and colposcopy was 81%, between colposcopy and histopathology was 90.6%, between cytology, colposcopy and histopathology was 90.6% and between cytology, colposcopy and histopathology was 87.3%. Conclusion Combination of various methods increases the diagnostic accuracy over that of each method separately. How to cite this article Jyothi R, Gupta P, Rao R, Sood PL, Parasher N. Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India. J South Asian Feder Menopause Soc 2013;1(1):21-23.

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Incidence of Lymph Node Metastases in Women With Low-Risk Early Cervical Cancer (<2 cm) Without Lymph-Vascular Invasion

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001236 ◽

2018 ◽

Vol 28 (4) ◽

pp. 788-793 ◽

Cited By ~ 1

Author(s):

Lucas Minig ◽

Anna Fagotti ◽

Giovanni Scambia ◽

Gloria Salvo ◽

María Guadalupe Patrono ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Lymph Node Involvement ◽

Pelvic Lymphadenectomy ◽

Low Risk ◽

Node Metastasis ◽

Vascular Space ◽

Vascular Space Invasion

ObjectiveTo determine the incidence of lymph node metastasis in women with low-risk cervical cancer stage IA2 or IB1 (<2 cm) without lymph-vascular space invasion.MethodsA multicenter retrospective study was performed in patients who underwent radical or simple hysterectomy, conization, or trachelectomy plus pelvic lymphadenectomy for cervical cancer between January 2000 and June 2016.ResultsA total of 271 patients were included in the study. Median age and body mass index were 46 years (range, 23–77 years) and 24 kg/m2 (range, 18–48 kg/m2), respectively. Twenty-two patients had stage IA2 (8.1%), and 249 (91.9%) had stage IB1. The median tumor size was 14 mm (range, 5–20 mm). Tumor grades were 1 (n = 63 [23.2%]), 2 (n = 120 [44.3%]), 3 (n = 63 [23.2%]), and unknown (25 [9.2%]). Median depth stromal invasion was 6 mm (range, 3–20 mm). Histologic subtypes included squamous (n = 171 [63.1%]), adenocarcinoma (n = 92 [33.9%]), and adenosquamous (n = 8 [3.0%]). Overall incidence of lymph node metastasis was 2.9% (n = 8). The incidence of lymph node involvement in G1, G2, and G3 was 0% (0/63), 5% (6/120), and 3.1% (2/63), respectively. No patient with stage IA2 (regardless of grade or histology) or G1 cervical cancer less than 2 cm (stage IB1) had lymph node metastasis.ConclusionsPatients with stage IA2 or IB1 (G1) with tumor size of less than 2 cm and no lymph-vascular space invasion may not need lymph node evaluation. On the other hand, 95% and 98% of patients with grade 2 or 3 tumors, respectively, could potentially undergo an unnecessary lymphadenectomy. Further studies with bigger sample size are required to confirm these results.

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A Combination of Serum Tumor Markers Identifies High-Risk Patients with Early-Stage Squamous Cervical Cancer

Tumor Biology ◽

10.1159/000132566 ◽

2008 ◽

Vol 29 (1) ◽

pp. 9-17 ◽

Cited By ~ 16

Author(s):

Elvira M. Davelaar ◽

Jonas van de Lande ◽

Silvia von Mensdorff-Pouilly ◽

Marinus A. Blankenstein ◽

René H.M. Verheijen ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Tumor Markers ◽

Early Stage ◽

Serum Tumor Markers ◽

High Risk Patients ◽

Squamous Cervical Cancer ◽

Risk Patients

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Risk factors of recurrence after adjuvant concurrent chemoradiotherapy following radical hysterectomy in high-risk patients with cervical cancer

Journal of Clinical Oncology ◽

10.1200/jco.2008.26.15_suppl.16543 ◽

2008 ◽

Vol 26 (15_suppl) ◽

pp. 16543-16543

Author(s):

H. Chung ◽

J. Kim ◽

N. Park ◽

Y. Song ◽

S. Kang ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

High Risk ◽

Radical Hysterectomy ◽

Concurrent Chemoradiotherapy ◽

High Risk Patients ◽

Risk Patients

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Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200605000-00036 ◽

2006 ◽

Vol 16 (3) ◽

pp. 1184-1187 ◽

Cited By ~ 1

Author(s):

K. B.M. Lee ◽

J. M. Lee ◽

C. Y. Park ◽

K. B. Lee ◽

H. Y. Cho ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cell Carcinoma ◽

Uterine Cervix ◽

Depth Of Invasion ◽

Node Metastasis ◽

Vascular Space ◽

Vascular Space Invasion

The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1–3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.

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