Six-Years Disease-Free Survival after Isolated Hypoxic Pelvic Perfusion with Chemofiltration for Advanced Cervical Carcinoma

BackgroundRecently, several studies observed that locally advanced cervical carcinoma with negative excision repair crross-complementation group one enzyme expression has better outcomes in cisplatin-based chemotherapy or chemoradiotherapy than carcinoma with positive excission repair cross-complementation group one enzyme expression. In this meta-analysis, we quantitatively evaluated the prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.MaterialsA systematic search for relevant studies was conducted in the PubMed, Cochrane Library, EMBASE and Medline databases. Fixed- or random-effects models were used for pooled analysis. The endpoints were overall survival and disease-free survival () reported as ORs and 95% CIs. The effects of excission repair cross-complementation group one enzyme expression on the clinicopathological parameters were measured by the pooled ORs and their 95% CIs.ResultsEight studies (612 patients in total) satisfied the inclusion criteria. Negative/low excission repair cross-complementation group one enzyme expression was significantly associated with better overall survival (OR, 1.92; 95% CI, 1.22 to 3.05; P = 0.005) and disease-free survival (OR, 5.77; 95% CI, 1.90 to 17.54; P = 0.002). Additionally, there were significant associations between excission repair cross-complementation group one enzyme expression and lymph node metastasis (OR, 2.57; 95% CI, 1.28 to 5.16; P = 0.008).ConclusionsThis meta-analysis suggested that pretreatment excission repair cross-complementation group one enzyme expression might be a useful biomarker to predict prognoses for locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.

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The Influence of Cisplatin Dose upon Survival in Concurrent Chemoradiotherapy of Locally Advanced Cervical Carcinoma with Weekly Cisplatin

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.9 ◽

2008 ◽

Vol 51 (2) ◽

pp. 95-99 ◽

Cited By ~ 6

Author(s):

Igor Sirák ◽

Jiří Petera ◽

Zdeněk Zoul

Keyword(s):

Overall Survival ◽

Cervical Carcinoma ◽

Concurrent Chemoradiotherapy ◽

Locally Advanced ◽

Disease Free Survival ◽

Hematological Toxicity ◽

High Dose ◽

Free Survival ◽

Disease Free ◽

Weekly Cisplatin

The objective of this study was to evaluate the influence of cisplatin dose upon 3-year overall and disease-free survival rate of patients with advanced cervical cancer treated with concurrent chemoradiotherapy with weekly cisplatin. Seventy-three patients with stage IIB – IVA cervical carcinoma were treated with pelvic (or pelvic + paraaortic) externalbeam radiotherapy, high-dose rate brachytherapy and concomitant chemotherapy with weekly cisplatin of 40 mg/m2 in the time period form January 2000 to December 2006 at our department. The 3-year overall survival and disease-free suvival rates were evaluated with regard to the number of cisplatin cycles applied during the external radiotherapy. Only twentyeight patients received the intended five doses of chemotherapy. The most frequent cause of chemotherapy delay was the acute hematological toxicity with leukopenia. The 3-year overall survival was 71 % and the 3-year disease-free survival was 61 %. Survival analyses didn’t prove a statistically significant influence of cisplatin dose upon 3-year survival in cervical carcinoma patients treated by exclusive chemoradiation with weekly cisplatin.

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Prognostic Impact of Histopathology in Patients with Advanced Stage Cervical Carcinoma Treated with Radiotherapy

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v37i4.43346 ◽

2019 ◽

Vol 37 (4) ◽

pp. 175-180

Author(s):

Nasrin Hossain ◽

Rahana Perveen ◽

Mohammed Sharif Mahmud ◽

Mohammed Kabirul Hassan

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Cervical Carcinoma ◽

Squamous Cell ◽

Disease Free Survival ◽

Advanced Stage ◽

Free Survival ◽

Histopathological Type ◽

Disease Free

Introduction: Cervical cancer is the fourth most common cancer in women worldwidev . Most patients in developing countries including Bangladesh present at advanced stage. Histopathological types of cervical cancer influence the treatment outcome when treated by radiation therapy. Objective: To determine the disease free survival (DFS) in different histopathological types in advanced stage cervical carcinoma treated with radiotherapy. Methods: A prospective cohort study was conducted in Gynaecological oncology outpatient department (GOPD) of National institute of Cancer Research & Hospital (NICRH), Dhaka for one year from September’2016 to July’2017. Advanced stage (IIB-IVB) cervical cancer who completed radiation therapy and histopathological type either squamous cell carcinoma or adenocarcinoma of cervix were included in this study. Results: The median follow-up time was 1.82 years; range was 8 to 24 months. Average disease free survival (DFS) was 1.53years in squamous cell carcinoma (SSC) and 1.51 years in adenocarcinoma (ADC). Local recurrences was higher in adenocarcinoma group (62.5%) than squamous cell carcinoma (30.5%) & the difference was statistically significant (p = 0.001). Loco-regional recurrence and distal recurrence were also higher in ADC than SSC but results were not statistically significant (p=.345, p=.795). In multivariate analysis it was shown that histopathological type and stage of disease were found to be independently significant prognostic factors for DFS, hazard ratio were 1.766 (p=.018) and 2.173 (p=.006). Conclusion: Adenocarcinoma was a poor prognostic factor for patients with locally advanced cervical carcinoma. Advanced stage of disease was also significant predictor for disease free survival. J Bangladesh Coll Phys Surg 2019; 37(4): 175-180

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ANALYSIS OF TREATMENT OUTCOMES IN LOCALLY ADVANCED CERVICAL CARCINOMA - AN INSTITUTIONAL STUDY

10.36106/ijsr/6204770 ◽

2021 ◽

pp. 55-57

Author(s):

S. Selvalakshmi

Keyword(s):

Treatment Failure ◽

Cervical Carcinoma ◽

Locally Advanced ◽

Disease Free Survival ◽

Treatment Modalities ◽

Early Age ◽

Carcinoma Cervix ◽

Free Survival ◽

Screening Programs ◽

Advanced Cervical Carcinoma

Introduction:Carcinoma cervix is the second most common cancer among women in India. Carcinoma cervix is associated with many risk factors such as multi parity, early age at marriage, early age at coitus and the most important basic cause is poor socioeconomic status, illiteracy, lack of proper self-hygiene, lack of awareness of screening programs and treatment modalities. The main objective of this study is to analyze various outcomes following treatment of locally advanced carcinoma cervix and also to determine the causes of treatment failure so as to improve disease free survival, progression free survival and overall survival. Materials And Methods: A retrospective study was conducted among 191 locally advanced cervical carcinoma patients treated in the Department of Radiotherapy, Stanley Medical College and Hospital, Chennai during the period between 2015 and 2019. Various parameters of our study included age distribution, chief complaints at presentation, histopathological types and grades, staging, type of treatment, details of brachytherapy, response assessment and follow up. Results: Majority of them belong to stage II(50%) followed by stage III (41%). 14 patients belong to stage IV and only 4 patients belong to stage I. Among them 102 patients (53.4%) showed complete response and 34 patients (17.8%) showed partial response. Discussion: Most of the patients were in 4th and 5th decade which is very close to TNCRPregistry. Stage grouping of patients is considered most signicant in assessing the outcome of the treatment wherein it was found necessary to identify and present the symptoms at early stage to fasten the treatment and aim at complete cure. Conclusion: This study brings a clear picture of the possible reasons for treatment failure in locally advanced cervical carcinoma and highlights necessary steps to be implemented in improving infrastructure facilities in Government hospitals that would result in better treatment for poor patients with maximum benets.

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