scholarly journals Prevalence of Para-Aortic Lymphadenopathy in Locally Advanced Cervical Cancer using Computed Tomography: A Retrospective Study

2020 ◽  
Author(s):  
Garba Haruna Yunusa ◽  
Usman Malami Aliyu
Keyword(s):  
Cervical Cancer ◽  
Retrospective Study ◽  
Cell Carcinoma ◽  
Cervical Carcinoma ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Figo Stage ◽  
University Teaching ◽  
Advanced Cervical Carcinoma

Introduction: Determination of status of Para-Aortic Lymph Node (PALN) in patients with cervical cancer is one of the most important factors guiding the treatment. It is essential in determining individualised therapy and prognosis. Aim: To assess the prevalence of para-aortic lymphadenopathy among patients with advanced cervical carcinoma referred for radiotherapy. Materials and Methods: A retrospective study of patients referred to Radiotherapy and Oncology Department of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria was carried out. Patient demographics, history of co-morbid conditions, histology, stage at diagnosis, and Computed Tomographic (CT) scan findings of enlarged PALN greater or equal to 10 mm in short axis diameter were retrieved. Data was analysed using IBM SPSS statistics version 23. Results: A total of 220 patients, age range 27-84 years with mean age 49.95±11.96 years were studied. The histological diagnosis were squamous cell carcinoma in 182 (87.2%), adenocarcinoma in 22 (10%), clear cell carcinoma in 9 (4.1%) while 7 (3.2%) patients had other histological variants. Co-morbities found were chronic cervicitis and HIV in 27 (12.3%) and 19 (8.6%) of the patients, respectively. CT prevalence of PALN was 23 (10.5%). The prevalence of PALN according to International Federation of Gynaecology and Obstetrics (FIGO) stage were 4.3%, 17.4%, 34.8%, 30.4% and 13.0% in stages IIB, IIIA, IIIB, IVA and IVB, respectively. Clinical stage determined based on physical examination and imaging findings, was shown to be related to PALN by univariate analysis (χ2=29.162, p=0.0001). Conclusion: This study found a 10.5% prevalence of para-aortic lymphadenopathy and a significant relationship between clinical stage and PALN. This should be taken into consideration during treatment planning for patients with advanced cervical carcinoma.

scholarly journals Concurrent chemoradiation in treatment of carcinoma cervix

1970 ◽  
Vol 2 (1) ◽  
pp. 4-8
Author(s):  
Meeta Singh ◽  
Rajshree Jha ◽  
Josie Baral ◽  
Suniti Rawal
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Advanced Cervical Cancer ◽  
European Organization ◽  
Locally Advanced Cervical Cancer ◽  
Advanced Cervical Carcinoma ◽  
To Come

Aim: to compare if concurrent chemoradiation is better than radiotherapy given alone in the treatment of women with locally advanced cervical cancer from published literature Method: Study Design: Randomized control trials of > than 2, 403 women participants who underwent treatment for advanced cervical carcinoma mainly in two huge center i.e. from National Cancer Institute (NCI), USA and European Organization for Research and Treatment of Cancer (EORTC) were reviewed regarding the treatment they received at the center: concurrent chemoradiation/ radiation therapy alone. The results were analyzed to come to conclusion. Result demonstrated a 30-50% improvement in survival when cisplatin-based chemotherapy in NCI or 5 fluorouracil and cisplatin based chemotherapy was used in EORTC was administered with concurrent radiation therapy (chemoradiation) Conclusions: The addition of chemotherapy (cisplatin) in NCI and (cisplatin and fluorouracil) in the EORTC for the treatment of locally advanced cervical cancer with the concurrent chemoradition have elicited better survival than those treated with radiotherapy alone dittoed by several other trials which can be anticipated to benefit Nepalese women with locally advanced cervical carcinoma. Key-words: Cancer cervix, chemoradiation, radiotherapy   doi:10.3126/njog.v2i1.1467 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 4 - 8 May -June 2007

A new marker based on risk stratification of human papillomavirus DNA and tumor size to predict survival of locally advanced cervical cancer

2019 ◽  
Vol 29 (3) ◽  
pp. 459-465 ◽  
Author(s):  
Yecai Huang ◽  
Qiao He ◽  
Ke Xu ◽  
Jie Zhou ◽  
Jun Yin ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Risk Stratification ◽  
Tumor Size ◽  
Locally Advanced ◽  
Figo Stage ◽  
Advanced Cervical Cancer ◽  
Hpv Dna ◽  
Locally Advanced Cervical Cancer ◽  
Advanced Cervical Carcinoma

ObjectiveTo assess the prognostic value of human papillomavirus (HPV) viral load in locally advanced cervical carcinoma treated with radical concurrent chemoradiotherapy.MethodsFrom January 2012 to October 2013, a total of 246 locally advanced cervical carcinoma patients were included in this retrospective study. HPV DNA status was tested by Hybrid Capture 2 assay. Tumor size was measured on T2WI. All the patients in the study received concurrent cisplatin-based chemoradiotherapy with intensity-modulated radiotherapy and three-dimensional brachytherapy. Survival rate was calculated by the Kaplan-Meier method, and a log-rank test was used to compare the survival. Multivariate analysis employed the Cox regression model.ResultsThe median follow-up time was 52 months. The median value of HPV DNA was 163.13 relative light unit/cut-off (RLU/CO) (range 1.65–2162.62 RLU/CO). The 5-year overall survival, distant metastasis-free survival of patients in the low HPV DNA group (HPV DNA ≤ 163.13 RLU/CO) and the high HPV DNA group (HPV DNA > 163.13 RLU/CO) were 46.3 % vs 58.5 % (p = 0.009) and 65.9 % vs 75.6% (p = 0.003), respectively. Multivariate analysis showed that the HPV DNA, tumor size, and International Federation of Gynecology and Obstetrics (FIGO) stage were independent prognostic factors for overall survival and distant metastasis-free survival. We choose the tumor size and HPV DNA as the risk stratification factors to build a new prediction marker which can better predict overall survival for locally advanced cervical cancer than can the FIGO stage.ConclusionsHPV DNA may be a useful biomarker for locally advanced cervical cancer. Low HPV load predicts a worse survival. The new marker based on risk stratification by combining HPV DNA and tumor size is better associated with overall survival of locally advanced cervical cancer treated with concurrent chemoradiotherapy.

MRI-based radiomics: promise for locally advanced cervical cancer treated with a tailored integrated therapeutic approach

2021 ◽  
pp. 030089162110142
Author(s):  
Concetta Laliscia ◽  
Angiolo Gadducci ◽  
Roberto Mattioni ◽  
Francesca Orlandi ◽  
Sabina Giusti ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Figo Stage ◽  
High Dose ◽  
Advanced Cervical Cancer ◽  
Primary Tumor Site ◽  
Locally Advanced Cervical Cancer ◽  
Sequential Boost

Objective: To assess prognostic factors by analyzing clinical and radiomic data of patients with locally advanced cervical cancer (LACC) treated with definitive concurrent cisplatin-based chemoradiotherapy (CCRT) using magnetic resonance imaging (MRI). Methods: We analyzed radiomic features from MRI in 60 women with FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IVA cervical cancer who underwent definitive CCRT 45–50.4 Gy (in 25–28 fractions). Thirty-nine (65.0%) received EBRT sequential boost (4–20 Gy) on primary tumor site and 56 (93.3%) received high-dose-rate brachytherapy boost (6–28 Gy) (daily fractions of 5–7 Gy). Moreover, 71.7% of patients received dose-dense neoadjuvant chemotherapy for 6 cycles. The gross tumor volume was defined on T2-weighted sequences and 29 features were extracted from each MRI performed before and after CCRT, using dedicated software, and their prognostic value was correlated with clinical information. Results: In univariate analysis, age ⩾60 years and FIGO stage IB2–IIB had significantly better progression-free survival (PFS) ( p = 0.022 and p = 0.009, respectively). There was a trend for significance for worse overall survival (OS) in patients with positive nodes ( p = 0.062). In multivariate analysis, only age ⩾60 years and FIGO stage IB2–IIB reached significantly better PFS ( p = 0.020 and p = 0.053, respectively). In radiomic dataset, in multivariate analysis, pregray level p75 was significantly associated with PFS ( p = 0.047), pre-D3D value with OS ( p = 0.049), and preinformation measure of correlation value with local control ( p = 0.031). Conclusion: The combination of clinical and radiomics features can provide information to predict behavior and prognosis of LACC and to make more accurate treatment decisions.

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

Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions

2007 ◽  
Vol 25 (20) ◽  
pp. 2952-2965 ◽  
Author(s):  
Bradley J. Monk ◽  
Krishnansu S. Tewari ◽  
Wui-Jin Koh
Keyword(s):  
Cervical Cancer ◽  
Cervical Carcinoma ◽  
State Of The Art ◽  
Locally Advanced ◽  
Multimodality Therapy ◽  
Advanced Cervical Cancer ◽  
Future Directions ◽  
Risk Of Death ◽  
Locally Advanced Cervical Cancer ◽  
Advanced Cervical Carcinoma

Globally, cervical cancer is the second most common cause of cancer-related mortality among women causing approximately 234,000 deaths annually among developing countries and killing 40,000 in developed nations. Most of these deaths occur in women with bulky or locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stages IIB through IVA, when lesions are not amenable to high cure rates with surgery or radiation (RT). The standard prescription for RT used to treat locally advanced cervical cancer has been dictated by common practice and patterns of care studies. In contrast, the addition of concomitant chemotherapy to RT has been studied in a number of randomized prospective trials, which are discussed in detail. When added to RT, cisplatin reduces the relative risk of death from cervical carcinoma by approximately 50% by decreasing local/pelvic failure and distant metastases. In 1999, weekly intravenous cisplatin at 40 mg/m2 for 6 weeks in combination with RT was established as a new standard for the treatment of locally advanced cervical carcinoma. More recently, this recommendation has been expanded to include women with FIGO stage IB2 lesions as well as those with bulky stage IIA cancers. This monograph reviews the state of the art in treating locally advanced cervical cancer with combined chemotherapy and RT and discusses clinical and pathologic prognostic factors that impact cure. Quality of life during and after multimodality therapy is considered as well as ongoing clinical trials and future directions.

Enhanced Radiosensitization with Interferon-α-2b and Cisplatin in the Treatment of Locally Advanced Cervical Carcinoma

1997 ◽  
Vol 67 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Richard G. Stock ◽  
Peter Dottino ◽  
T.Scott Jennings ◽  
Mitchell Terk ◽  
J.Keith Dewyngaert ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Interferon Α ◽  
Advanced Cervical Carcinoma

Audiological findings in a Phase I protocol investigating the effect of WR 2721, high-dose cisplatin and radiation therapy in patients with locally advanced cervical carcinoma

1995 ◽  
Vol 109 (8) ◽  
pp. 744-747 ◽  
Author(s):  
John S. Rubin ◽  
Scott Wadler ◽  
Jonathan J. Baitler ◽  
Hilda Haynes ◽  
Alla Rozenblet ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Phase I ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Hearing Threshold ◽  
High Dose ◽  
High Frequencies ◽  
Advanced Cervical Carcinoma ◽  
Before And After ◽  
Audiologic Testing

AbstractWR 2721 (ethiofos) protects against the toxic effects of the heavy metal compound cisplatin. which is used in the treatment of solid tumours. In a Phase I protocol designed to determine the maximum dose of WR 2721 which could be tolerated when administered in combination with cisplatin and radiation therapy to patients with cervical carcinoma. 11 patients were evaluated by audiologic testing before and after cisplatin WR 2721 administration in an attempt to identify the degree of ototoxicity. Forty-five per cent were noted to have significant hearing threshold changes. predominantly in the high frequencies. There were no significant changes in the speech frequencies in this series. This contrasts with the greater degrees of ototoxicity observed in controls treated in the same way who received cisplatin without WR 2721 protection.

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