scholarly journals P16 and HPV Genotype Significance in HPV-Associated Cervical Cancer—A Large Cohort of Two Tertiary Referral Centers

2021 ◽  
Vol 22 (5) ◽  
pp. 2294
Author(s):  
Sara da Mata ◽  
Joana Ferreira ◽  
Inmaculada Nicolás ◽  
Susana Esteves ◽  
Gonçalo Esteves ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Advanced Disease ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Figo Stage ◽  
Hpv Infection ◽  
Gynecology And Obstetrics ◽  
Worse Prognosis ◽  
P16 Expression ◽  
P16 Overexpression

The expression of p16 is a good surrogate of human papillomavirus (HPV) infection in HPV-associated cancers. The significance of p16 expression, HPV genotype and genera in the outcome of patients with HPV-associated cervical cancer (CC) is unclear. Our aim is to ascertain the prognostic significance of these factors. Data from 348 patients (median age: 47.5 years old) with CC, diagnosed in two referral centers, were retrospectively collected. Advanced disease (FIGO2018 IB2-IV) was present in 68% of patients. A single HPV genotype was identified in 82.8% of patients. The most common HPVs were HPV16 (69%) and HPV18 (14%). HPV genera reflected this distribution. HPV16 tumors presented at an earlier stage. P16 was negative in 18 cases (5.2%), 83.3% of which were squamous cell carcinomas. These cases occurred in older patients who tended to have advanced disease. In the univariate analysis, HPV16 (HR: 0.58; p = 0.0198), α-9 genera (HR: 0.37; p = 0.0106) and p16 overexpression (HR: 0.54; p = 0.032) were associated with better survival. HPV16 (HR: 0.63; p = 0.0174) and α-9 genera (HR: 0.57; p = 0.0286) were associated with less relapse. In the multivariate analysis, only the International Federation of Gynecology and Obstetrics (FIGO) stage retained an independent prognostic value. HPV16, α-9 genera and p16 overexpression were associated with better survival, although not as independent prognostic factors. Patients with p16-negative HPV-associated CC were older, presented with advanced disease and had worse prognosis.

The prognostic significance of leukocytosis in cervical cancer

2007 ◽  
Vol 17 (2) ◽  
pp. 465-470 ◽  
Author(s):  
A. Garcia-Arias ◽  
L. Cetina ◽  
M. Candelaria ◽  
E. Robles ◽  
A. Dueñas-González
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Medical Records ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Prognostic Significance ◽  
Complete Response ◽  
Figo Stage ◽  
Tumor Type ◽  
Advanced Stages

Cervical cancer is a frequent tumor with established prognostic factors such as FIGO stage and hemoglobin levels among others. Despite the fact that paraneoplastic leukocytosis is relatively common in many solid tumors, only isolated cases of cervical cancer patients presenting this abnormality have been published; hence, the clinical significance of leukocytosis is unknown in this tumor type. Retrospective review on the medical records of 294 consecutive newly diagnosed and untreated locally advanced cervical cancer patients who received radiotherapy and concurrent cisplatin was conducted. Leukocytosis was defined as a persistent white blood cell count exceeding 10,800/μL, determined at least twice before commencing chemoradiation providing that patients were free of any active acute or chronic infection or any other condition known to elevate the leukocyte count. The frequency of leukocytosis and their correlation with clinicopathologic features were investigated, as well as their impact on tumor response and survival. Leukocytosis with a median value of 13,300/μL (11,100–28,800) was observed in 35 (11.9%) patients at diagnosis. Leukocytosis was statistically associated only with advanced stages. Clinical complete response was observed in 57% versus 86% of the patients with and without leukocytosis, respectively. In the univariate analysis, leukocytosis, stage, and hemoglobin levels were significant predictors of survival; however, only leukocytosis and the hemoglobin level remained significant predictors of survival in the multivariate analysis. Leukocytosis is common in cervical cancer patients and has a negative prognostic significance

scholarly journals The Prognostic Value of Peripheral Inflammatory Cell Ratios in Patients with Cervical Cancer After Radiotherapy

2021 ◽  
Author(s):  
Ruizhe Xu ◽  
Haiyan Lu ◽  
Qi Guo ◽  
Jianjun Qian ◽  
Qiuhong Fan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Inflammatory Cell ◽  
Univariate Analysis ◽  
Figo Stage ◽  
Lymph Node Status ◽  
Tumor Diameter ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gynecology And Obstetrics

Abstract Introduction: This study aimed to explore the values of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as prognostic biomarkers in patients with cervical cancer.Methods: In total, 172 cervical cancer patients treated with radiotherapy between January 2014 and December 2017 were retrospectively identified. We calculated the NLR and PLR and determined their cut-off points, known prognostic factors, and the association of these factors with overall survival (OS).Results: The median follow-up period was 59 months (range 1–91 months, 95% confidence interval 53–63 months). The 3- and 5-year OS rates of patients who received postoperative adjuvant radiotherapy were 86.7% and 79.7%, respectively, while the 3- and 5-year OS rates of patients who received radical radiotherapy were 70.2% and 61.6%, respectively. Univariate analysis identified that OS was significantly correlated with tumor diameter, pelvic lymph node status, the NLR and PLR before radiotherapy, past diabetes, International Federation of Gynecology and Obstetrics (FIGO) stage, the purpose of radiotherapy, pathology type, and the OS rate (all P<0.05). On multivariate analysis, the PLR before radiotherapy, past diabetes, FIGO stage, and pathology type were independently associated with OS (all P<0.05). Conclusions: The NLR and PLR before radiotherapy are correlated with the prognosis of cervical cancer. Furthermore, the PLR before radiotherapy is an independent risk factor related to OS.

The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

2018 ◽  
Vol 28 (7) ◽  
pp. 1297-1310 ◽  
Author(s):  
Michael J. Nathenson ◽  
Anthony P. Conley ◽  
Heather Lin ◽  
Nicole Fleming ◽  
Alexander Lazar ◽  
...  
Keyword(s):  
Survival Data ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Gynecology And Obstetrics ◽  
Resection Status

ObjectiveThis retrospective study examined the clinicopathologic features of adenosarcoma patients to determine potential prognostic factors and retrospectively evaluated overall survival (OS), disease-free survival (DFS), and local recurrence-free survival (LRFS) after primary treatment of adenosarcoma including surgery, radiation, and chemotherapy.MethodsOne hundred sixty-five patients with adenosarcoma were identified from the MD Anderson Cancer Center tumor registry between 1982 and 2014. Clinical data were collected retrospectively. Pathologic characteristics were examined by sarcoma pathologists. We used the Kaplan-Meier method to estimate OS, DFS, and LRFS. The log-rank test was performed to test the difference in survival between groups. Multivariate regression analyses of survival data were conducted using the Cox proportional hazards model.ResultsMedian OS and DFS for all patients were 8.5 and 4.7 years, respectively. Pathologic characteristics that influence OS and DFS were sarcomatous overgrowth (SO), myometrial invasion (MI), lymphovascular invasion (LVI), tumor size, number of mitosis, estrogen receptor, progesterone receptor, International Federation of Gynecology and Obstetrics (FIGO) stage, age, and resection status. Median OS for adenosarcoma patients with SO was 5.2 versus 14.5 years for patients without SO (P < 0.0001). Median OS for adenosarcoma patients with MI was 5.8 years versus not reached for patients without MI (P = 0.0005). Median OS for adenosarcoma patients with LVI was 1.0 versus 8.9 years for patients without LVI (P = 0.0021). On Cox analysis for OS and DFS and LRFS, only SO, MI, LVI, age, resection status, and FIGO stage remained significant. There was no difference in OS or LRFS for adjuvant radiation versus no adjuvant radiation (P = 0.17, P = 0.076).ConclusionsThis study highlights the importance of LVI as a prognostic factor and confirms the prognostic significance of SO, MI, age, resection status, and FIGO stage for adenosarcoma. Furthermore, this study suggests that there is no additional benefit to adjuvant radiation. The standard-of-care treatment for adenosarcoma should remain total abdominal hysterectomy bilateral salpingo-oophorectomy +/− lymphadenectomy and no adjuvant radiation.

scholarly journals Treatment of cervical cancer in the Republic of Srpska

2011 ◽  
Vol 64 (11-12) ◽  
pp. 588-591 ◽  
Author(s):  
Nenad Lucic ◽  
Zora Antonic ◽  
Vesna Ecim ◽  
Dragica Draganovic ◽  
Ljiljana Latinovic
Keyword(s):  
Cervical Cancer ◽  
Postoperative Complications ◽  
Radical Hysterectomy ◽  
Invasive Cervical Cancer ◽  
Figo Stage ◽  
International Federation ◽  
Gynecology And Obstetrics ◽  
The Republic ◽  
Banja Luka ◽  
Cervical Tumors

Introduction. Since 1897, when the first radical hysterectomy with lymphadenectomy was done by Wertheim in Vienna, this operation has had the central role in the surgical treatment of invasive cervical tumors. Material and methods. In the period from 1997 to 2010, 177 patients diagnosed with invasive cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 - II were operated at the Department of Obstetrics and Gynecology in Banja Luka. All patients underwent radical hysterectomy by Wertheim - Meigs. The aim of this study is to present the technique of this operation, as well as its effectiveness in the treatment of cervical cancer. Results. The distribution of the patients having invasive cervical cancer according to the International Federation of Gynecology and Obstetrics classification was as follows: I B1 - 35.67%, I B2 - 23.17%, II A - 15.48%, II B - 25.68% on average is 21.3 removed lymph glands. The rate of intraoperative and postoperative complications was 8 (4.51%) and 17 (9.60%), respectively. Of the 26 patients who were operated in the period from 2005 - 2010, 13 had stage II B according to the International Federation of Gynecology and Obstetrics; there were 6 lethal outcomes (23.08) and the five-year survival rate was 76.92%. Discussion and conclusion. By applying the proper surgical technique and early prevention of immediate complications, we achieved satisfactory results in operative morbity and mortality, intraoperative and postoperative complications of the lesion for radical surgery by the Wertheim- Meigs-in the treatment of cancer of the uterus in the I B - II B stage according to the International Federation of Gynecology and Obstetrics classification.

Persistent opioid use after radiation therapy in opioid-naive cervical cancer survivors

2019 ◽  
Vol 29 (7) ◽  
pp. 1105-1109 ◽  
Author(s):  
Kelsey Ward ◽  
Amin Ramzan ◽  
Jeanelle Sheeder ◽  
Stacy Fischer ◽  
Carolyn Lefkowits
Keyword(s):  
Cervical Cancer ◽  
Substance Abuse ◽  
Cancer Survivors ◽  
Multivariable Analysis ◽  
Figo Stage ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Gynecology And Obstetrics ◽  
History Of ◽  
Disease Free

ObjectivesOpioids are first-line therapy for cancer-related pain, but their use should be minimized in disease-free survivors. We sought to describe rates and identify predictors of persistent opioid use among previously opioid-naive cervical cancer survivors treated with radiation.MethodsOpioid-naive cervical cancer patients treated primarily with radiation and chemosensitization at a single institution, between January 2011 and December 2015, were identified. Charts were reviewed for demographics, disease, and treatment characteristics, and opioid prescriptions. Primary outcome was persistent opioid use, defined as continued opioid prescription use, 6 months after radiation; patients recurring within 6 months were excluded. Groups were compared using χ2 or Fisher’s exact test. Multivariable logistic regression identified predictors of persistent opioid use.ResultsA total of 96 patients were included, with a median age of 49 years (range 27–84). Most patients (59%) at diagnosis had International Federation of Gynecology and Obstetrics (FIGO) stage I or II cervical cancer. The most common histology was squamous cell carcinoma (72%) and most (94.7%) patients received radiation with chemosensitization. Rates of persistent opioid use at 3 and 6 months after treatment were 29% and 25%, respectively. Persistent users were more likely to be <40 years old, have disease outside the pelvis at diagnosis, and have had a history of substance abuse, depression or anxiety (p<0.05). In multivariable analysis, a history of substance abuse (adjusted OR 6.21, 95% CI 1.08 to 35.67) and depression or anxiety (aOR 6.28, 95% CI 1.70 to 23.30) were independently associated with persistent opioid use.ConclusionOur study showed that 25% of patients with cervical cancer were still using opioids 6 months after radiation. History of substance abuse and depression or anxiety, all known risk factors for opioid misuse, were associated with persistent use. The goal in the disease-free survivor population should be opioid independence.

scholarly journals Synergetic Effects of Intronic Mature miR-944 and ΔNp63 Isoforms on Tumorigenesis in a Cervical Cancer Cell Line

2020 ◽  
Vol 21 (16) ◽  
pp. 5612
Author(s):  
Jungho Kim ◽  
Sunyoung Park ◽  
Yunhee Chang ◽  
Kwang Hwa Park ◽  
Hyeyoung Lee
Keyword(s):  
Cervical Cancer ◽  
Epithelial Mesenchymal Transition ◽  
Cancer Cell Line ◽  
Gene Clusters ◽  
Figo Stage ◽  
Cervical Cancer Cell Line ◽  
Mesenchymal Transition ◽  
Gynecology And Obstetrics ◽  
Simultaneous Inhibition ◽  
Cancer Tissues

miR-944 is located in an intron of the tumor protein p63 gene (TP63). miR-944 expression levels in cervical cancer tissues are significantly higher than in normal tissues and are associated with tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, and survival. However, associations of miR-944 with its host gene, TP63, which encodes TAp63 and ΔNp63, in cervical cancer have not been fully investigated. A positive correlation between miR-944 and ΔNp63 mRNA expression was identified in cervical cancer tissues. Furthermore, when the expression of miR-944 and ΔNp63 was simultaneously inhibited, cell proliferation-, differentiation- epithelial–mesenchymal transition (EMT)-, transcription-, and virus-associated gene clusters were shown to be significantly more active according to functional annotation analysis. Cell viability and migration were more reduced upon simultaneous inhibition with anti-miR-944 or ΔNp63 siRNA than with inhibition with anti-miR-944 or ΔNp63 siRNA alone, or scramble. In addition, Western blot analysis showed that the simultaneous inhibition of miR-944 and ΔNp63 reduced EMT by increasing the expression of epithelial markers such as claudin and by decreasing mesenchymal markers such as N-cadherin and vimentin. Slug, an EMT transcription factor, was also decreased by the simultaneous inhibition of miR-944 and ΔNp63. Thus, associations between miR-944 and ΔNp63 in cervical cancer could help to elucidate the function of this intronic microRNA and its role in carcinogenesis.

Oncologic and obstetric outcomes after simple conization for fertility-sparing surgery in FIGO 2018 stage IB1 cervical cancer

2021 ◽  
Vol 31 (3) ◽  
pp. 452-456
Author(s):  
Francesco Fanfani ◽  
Luigi Pedone Anchora ◽  
Giampaolo Di Martino ◽  
Nicolò Bizzarri ◽  
Maria Letizia Di Meo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Early Stage ◽  
Fetal Loss ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Oncologic Outcomes ◽  
Obstetric Outcomes ◽  
Gynecology And Obstetrics ◽  
Fertility Sparing

ObjectiveConization/simple trachelectomy is feasible in patients with early-stage cervical cancer. Retrospective data suggest that conization with negative lymph nodes could be a safe option for these patients. This study aims to provide oncologic and obstetric outcomes of a large series of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer managed by conization.MethodsPatients with early cervical cancer and a desire to preserve fertility who underwent conization and pelvic lymphadenectomy from January 1993 to December 2019 in two Italian centers were included. Inclusion criteria were: age >18 years and ≤45 years, 2018 FIGO stage IB1, no prior irradiation or chemotherapy, absence of pre-operative radiologic evidence of nodal metastases, a strong desire to preserve fertility, and absence of concomitant malignancies. We excluded patients with confirmed infertility, neuroendocrine tumor, clear cell or mucinous carcinoma.ResultsA total of 42 patients were included. The median age was 32 years (range 19–44) and median tumor size was 11 mm (range 8–20). Squamous cell carcinoma was found in 27 (64.3%). Grade 3 tumor was present in 7 (16.7%) patients and lymphovascular space involvement was detected in 15 (35.7%). At a median follow-up of 54 months (range 1–185), all patients were alive without evidence of disease. In the entire series three patients experienced recurrence resulting in an overall recurrence rate of 7.1%. All the recurrences occurred in the pelvis (2 in the cervix and 1 in the lymph nodes), resulting in a 3-year disease-free survival of 91.6%. Twenty-two (52%) patients tried to conceive; 18 pregnancies occurred in 17 patients and 12 live births were reported (6 pre-term and 6 term pregnancies). Two miscarriages were recorded, one first trimester and one second trimester fetal loss.ConclusionsOur study showed that conization is feasible for the conservative management of women with stage IB1 cervical cancer desiring fertility. Oncologic outcomes appear favorable in this series of patients. Future prospective studies will hopefully provide further insight into this important question.

The Prognostic Significance of Multiple Pelvic Node Metastases in Cervical Cancer Patients Treated With Radical Hysterectomy Plus Adjuvant Chemoradiotherapy

2012 ◽  
Vol 22 (3) ◽  
pp. 490-497 ◽  
Author(s):  
Mika Okazawa ◽  
Seiji Mabuchi ◽  
Fumiaki Isohashi ◽  
Osamu Suzuki ◽  
Yukinobu Ohta ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Prognostic Significance ◽  
Adjuvant Chemoradiotherapy ◽  
Treatment Groups ◽  
Pelvic Node ◽  
Gynecology And Obstetrics ◽  
Node Metastases

ObjectiveWe investigated the prognostic significance of multiple pelvic node metastases in cervical cancer patients who were treated with radical hysterectomy plus adjuvant chemoradiotherapy.MethodsWe retrospectively reviewed the medical records of 311 patients with International Federation of Gynecology and Obstetrics stage IB1-IIB cervical cancer who had been treated with radical hysterectomy plus adjuvant radiotherapy (RT) between January 1998 and December 2008. Of these, 119 received adjuvant RT and 192 received adjuvant concurrent chemoradiotherapy (CCRT) postoperatively. Multivariate analysis for progression-free survival (PFS) was performed using the Cox proportional hazards regression model to investigate the prognostic significance of pelvic node metastases in the 2 treatment groups. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.ResultsMultivariate analysis demonstrated pelvic node metastasis to be an independent prognostic factor for shorter PFS in both treatment groups. When the node-positive patients were analyzed according to the number of positive pelvic nodes, we found that the patients with multiple pelvic node metastases (≥3) displayed significantly shorter PFS than those with 1 or 2 pelvic node metastases in the RT group. In contrast, in the CCRT group, the PFS of the patients with multiple pelvic node metastases (≥3) was similar to that observed of the patients with 1 or 2 pelvic node metastases.ConclusionsThe presence of multiple pelvic node metastases was not an independent predictor of shorter PFS in the CCRT group.

Radiotherapy Improves the Survival of Patients With Metastatic Cervical Cancer: A Propensity-Matched Analysis of SEER Database

2018 ◽  
Vol 28 (7) ◽  
pp. 1360-1368 ◽  
Author(s):  
Kejie Huang ◽  
Mingfang Jia ◽  
Ping Li ◽  
Jianglong Han ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Nearest Neighbor ◽  
Proportional Hazards ◽  
Figo Stage ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Cancer Specific Survival ◽  
Gynecology And Obstetrics ◽  
End Results

ObjectiveTo demonstrate whether radiotherapy has an effect on the survival of patients with stage IVb (M1) cervical cancer, as it has not been adequately clarified.MethodsWe analyzed International Federation of Gynecology and Obstetrics (FIGO) stage M1 cervical cancer diagnosed in patients between 1992 and 2013 using population-based data from the Surveillance, Epidemiology, and End Results registry. Propensity score (PS) analysis with 1:1 matching and the nearest neighbor matching method was performed to ensure well-balanced characteristics of comparison groups. Data were analyzed by Kaplan-Meier and Cox proportional hazards regression models to evaluate the overall survival (OS) and cancer-specific survival (CSS) months with corresponding 95% confidence intervals (95% CIs).ResultsIn general, receiving radiotherapy significantly improved OS and CSS both before and after PS matching (PSM) (P< 0.001), with significantly improved OS (hazard ratio, 0.69; 95% CI, 0.62-0.76) and CSS (hazard ratio, 0.79; 95% CI, 0.70-0.89) after PSM in patients with stage M1 cervical cancer. Before PSM, radiotherapy was found to be associated with improved survival even for the patients with stage M1 cervical cancer with extensive metastasis (≥2 metastatic sites) (P< 0.001). AlthoughPvalue was not significant for brain metastasis, the survival month was numerically improved before PSM (OS and CSS, 1 month vs 4 months). Overall, radiotherapy still significantly improved survival for patients with one metastatic site (ie, oligometastases) either before or after PSM (P< 0.05), with the survival month improved more than 6 months.ConclusionsThe large Surveillance, Epidemiology, and End Results results support that radiotherapy might improve the survival of patients with metastatic cervical cancer. It might be prudent to carefully select suitable patients for radiation therapy for metastatic cervical cancer.

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