Outcome of Patients after Modified Radical Hysterectomy with Pelvic Lymphadenectomy in Early Stage Carcinoma Cervix: A Retrospective Study

2017 ◽  
Vol 16 (06) ◽  
pp. 43-49
Author(s):  
Singh Shashi Bala ◽  
Shrivastava Priyanka ◽  
Bharti Atima ◽  
Shrivastava Ramesh Kumar ◽  
Kumari Shilpa
Keyword(s):  
Retrospective Study ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Carcinoma Cervix ◽  
Early Stage Carcinoma

scholarly journals Audit on early stage carcinoma cervix primarily treated with radical surgery: A tertiary cancer care centre experience

2016 ◽  
Author(s):  
Adarsh Dharmarajan ◽  
M. Geetha
Keyword(s):  
Adjuvant Treatment ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pathological Finding ◽  
Clinical Staging ◽  
Treatment Modalities ◽  
Adjuvant Radiation ◽  
Carcinoma Cervix ◽  
Retrospective Audit ◽  
Early Stage Carcinoma

Introduction: Clinical staging is universally accepted for ca cervix. In early stage of carcinoma cervix both radiation and radical hysterectomy given equivalent local control rates as well as survival. Poor prognostic factors following surgery would necessitate-post-operative adjuvant radiation. Selecting the patients who is unlikely to require adjuvant treatment after surgery spares them the toxicity of multiple treatment modalities, which is worse than alone. Aim: To find out clinico-pathological correlation in early stage carcinoma cervix treated with the surgery. Materials and Methods: It is a retrospective audit of study. All carcinoma cervix cases primarily treated with surgery. Results: A total of 25 cases were treated in this study. The median age of patients observed with 48 years. The common symptoms and stage were vaginal discharge (i.e., 42.30%) and 1B1 (61.53%). Most of patients were treated with type III radical hysterectomy and their clinical staging was correlated with the final histo-pathological staging. A total of 11 (i.e., 42.30%) required adjuvant treatment among them 7 (63.633%), 1 (9.09%) and 3 (27.27%) patients were in 1B1 1B2 and 2A respectively. The chi-square test has been performed to compute the correlation between clinical and histo-pathological finding. It shows that significant amount of relation present between clinical and histo-pathological findings.

An observational longitudinal study to evaluate miction, defecation, and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer

2006 ◽  
Vol 16 (3) ◽  
pp. 1119-1129 ◽  
Author(s):  
Q. D. Pieterse ◽  
C. P. Maas ◽  
M. M. Ter Kuile ◽  
M. Lowik ◽  
M. A. Van Eijkeren ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Longitudinal Study ◽  
Sexual Function ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Control Group ◽  
Negative Effects ◽  
Early Stage Cervical Cancer

The objective of this study was to evaluate the problems with miction, defecation, and sexuality after a radical hysterectomy with or without adjuvant radiotherapy for the treatment of cervical cancer stage I–IIA. This study included an observational longitudinal study of self-reported bladder, defecation, and sexual problems with a baseline score. Ninety-four women were included in the study. An age-matched control group consisted of 224 women. The patients showed significantly more negative effects on sexual function compared with both the controls and their situation before the treatment throughout 24 months of follow-up. The problems included less lubrication, a narrow and short vagina, senseless areas around the labia, dyspareunia, and sexual dissatisfaction. Up to 12 months after the treatment, the patients complained significantly more of little or no urge to urinate and diarrhea as compared with the controls. Adjuvant radiotherapy did not increase the risk of bladder dysfunction, colorectal motility disorders, and sexual functions. We conclude that a radical hysterectomy for the treatment of early-stage cervical carcinoma is associated with adverse effects mainly on sexual functioning.

Twelve years experience with radical hysterectomy and pelvic lymphadenectomy in early stage cervical cancer

2010 ◽  
Vol 30 (3) ◽  
pp. 294-298 ◽  
Author(s):  
P. Suprasert ◽  
J. Srisomboon ◽  
K. Charoenkwan ◽  
S. Siriaree ◽  
C. Cheewakriangkrai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Early Stage Cervical Cancer

Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer

2017 ◽  
Vol 27 (6) ◽  
pp. 1222-1227 ◽  
Author(s):  
Tao Zhu ◽  
Xi Chen ◽  
Jianqing Zhu ◽  
Yaqing Chen ◽  
Aijun Yu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Tumor Diameter ◽  
Laparoscopic Radical Hysterectomy ◽  
Lymph Node Sampling ◽  
Aortic Lymph Node ◽  
Early Stage Cervical Cancer

Background and ObjectivesThe aim of this study was to compare the feasibility, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (LRH) with those of abdominal radical hysterectomy (ARH) for bulky early-stage cervical cancer.MethodsWe performed a retrospective cohort study of 112 patients with stage IB1 or IIA2 cervical cancer in which the tumor diameter was 3 cm or greater. All patients underwent LRH (n = 30) or ARH (n = 82) with pelvic lymphadenectomy and/or para-aortic lymph node sampling between May 2011 and November 2014. Perioperative outcomes were compared between the 2 surgical groups.ResultsThe laparoscopic approach consisted of 4 trocar insertions. Age, tumor diameter, and pelvic lymph nodes significantly differed between the 2 cohorts. Body mass index, International Federation of Gynecology and Obstetrics stage, histologic type and grade, deep stromal invasion, lymphovascular space invasion, positive margins, and adjuvant therapy were not significantly different between the 2 cohorts. Laparoscopic radical hysterectomy exhibited favorable results compared with ARH in terms of operating time, blood loss, intestinal exhaust time, and length of hospital stay. In addition, recurrence was observed in 5 LRH patients (16.7%) and 9 ARH patients (11.7%).ConclusionsThe surgical outcomes of LRH with pelvic lymphadenectomy and/or para-aortic lymph node sampling exhibited a similar therapeutic efficacy to those of the ARH approach.

Delayed adjuvant radiotherapy in early-stage cervical cancer with intermediate-risk features has a detrimental effect on survival that cannot be corrected by adjuvant chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6037-6037
Author(s):  
Joyson Kodiyan ◽  
Adel Guirguis ◽  
Hani Ashmalla
Keyword(s):  
Cervical Cancer ◽  
Adjuvant Chemotherapy ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Positive Margin ◽  
Pelvic Lymphadenectomy ◽  
Intermediate Risk ◽  
Early Stage Disease ◽  
Early Stage Cervical Cancer

6037 Background: GOG-0263 is currently investigating the role of adjuvant chemotherapy (CT) concurrently with radiotherapy (RT) in patients with early stage cervical cancer that underwent radical hysterectomy and pelvic lymphadenectomy harboring intermediate risk features. We used a retrospective database to investigate whether adjuvant chemotherapy significantly influenced overall survival (OS), and whether its effectiveness is influenced by delays in radiotherapy. Methods: All data was obtained from the NCDB (National Cancer Database) and initially contained 115,747 cases of cervical cancer diagnosed between 2004 and 2015. Analyzed patients had early stage disease, received radical hysterectomy with pathologic stage I to IIA, and had intermediate risk features including size greater than 4 cm or lymphovascular invasion. All patients received adjuvant RT with or without CT. Cases with positive margin or nodes, with parametrial extension, or metastasis were excluded. Cases were weighted by inverse probability of treatment (CT) using clinical and socioeconomic variables, and analyzed for OS using multivariate models. Predictors of receiving CT were determined using multivariate logistic regression. Results: The final cohort was 557 patients with median follow-up of 43 months (range, 1.54-143.7). Median survival without CT (n = 244) versus with CT (n = 313) was 42.2 versus 43.9 months (HR 0.81, 95%CI 0.661-0.995, p = 0.045). Median time from diagnosis to RT was 91 days (range, 21-691), and predicted for inferior OS (p = 0.007). No significant interaction existed between RT delay and receipt of CT (p = 0.997). Cases with squamous histology were less likely to receive CT than adenocarcinoma histology (OR 0.345, 95%CI 0.159-0.725, p = 0.006). Conclusions: Poor survival outcomes are observed in patients with early stage cervical cancer harboring intermediate risk features when adjuvant radiotherapy is delayed. This outcome was not corrected by addition of chemotherapy.

scholarly journals Small cell carcinoma of the uterine cervix during pregnancy

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131986653 ◽  
Author(s):  
Satoshi Eto ◽  
Kentaro Kai ◽  
Kaei Nasu ◽  
Masakazu Nishida ◽  
Haruto Nishida ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Uterine Cervix ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Japanese Woman ◽  
Small Cell ◽  
Definitive Therapy ◽  
Distant Spread

Small cell carcinoma of the uterine cervix is a rare histological entity that has a poor prognosis. We report the case of a patient with small cell carcinoma of the uterine cervix who underwent a radical hysterectomy during pregnancy. A 33-year-old Japanese woman with genital bleeding was referred at 15 weeks’ gestation. A speculum exam revealed a 5.4-cm-dia. mass in the cervix, and a cervical biopsy revealed small cell carcinoma of the uterine cervix. Imaging studies demonstrated a tumor confined to the cervix, swelling of intra-pelvic lymph nodes, and no distant spread of the tumor. She was diagnosed as having small cell carcinoma of the uterine cervix, stage IB2, and underwent a radical hysterectomy with pelvic lymphadenectomy. She refused any adjuvant therapies, had a systemic relapse 4 months after surgery, and died of the disease 5 months after surgery. Early-stage small cell carcinoma of the uterine cervix should be treated with a definitive therapy soon after diagnosis whether the patient is pregnant or not. Saving the mother’s life should be the top priority.

scholarly journals Clinical implication of oncogenic somatic mutations in early-stage cervical cancer with radical hysterectomy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Takafumi Watanabe ◽  
Hideaki Nanamiya ◽  
Manabu Kojima ◽  
Shinji Nomura ◽  
Shigenori Furukawa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Genetic Mutations ◽  
Mutation Status

Abstract It is well known that tumour initiation and progression are primarily an accumulation of genetic mutations. The mutation status of a tumour may predict prognosis and enable better selection of targeted therapies. In the current study, we analysed a total of 55 surgical tumours from stage IB-IIB cervical cancer (CC) patients who had undergone radical hysterectomy including pelvic lymphadenectomy, using a cancer panel covering 50 highly mutated tumorigenesis-related genes. In 35 patients (63.6%), a total 52 mutations were detected (58.3% in squamous cell carcinoma, 73.7% in adenocarcinoma), mostly in PIK3CA (34.5%) and KRAS and TP53 (9.1%). Being mutation-positive was significantly correlated with pelvic lymph node (PLN) metastasis (P = 0.035) and tended to have a worse overall survival (P = 0.076). In particular, in the patients with squamous cell carcinoma, there was a significant association between being mutation-positive and relapse-free survival (P = 0.041). The patients with PLN metastasis had a significantly worse overall survival than those without (P = 0.006). These results indicate that somatic mutation status is a predictive biomarker for PLN metastasis in early-stage CC, and is consequently related to poor prognosis. Therefore, comprehensive genetic mutations, rather than a single genetic mutation, should be examined widely in order to identify novel genetic indicators with clinical usefulness.

Is Primary Chemoradiation A Better Treatment? A Retrospective Study of Early Stage Node-positive Cervical Cancer.

2020 ◽  
Author(s):  
Nan Zhang ◽  
Hong Zheng
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Retrospective Study ◽  
Radical Hysterectomy ◽  
Radical Surgery ◽  
Early Stage ◽  
Progression Free Survival ◽  
Free Survival ◽  
Surgery Group ◽  
Significant Difference

Abstract Background. Cervical cancer is the second most frequently diagnosed cancer and the third leading cause of cancer death for women in developing countries. Radical hysterectomy with bilateral pelvic lymph node dissection is usually preferred for patients of stage IB1-IIA2. Currently, image examinations have certain limitations in diagnose of lymph node metastasis and their detection accuracies are not satisfactory. Only the pathological examination after removal of the suspected metastatic lymph nodes during surgery can conclusively identify the presence of metastasis. If there is a positive result of lymphatic metastasis, there is no clear guideline whether to complete a radical surgery, or to only conduct a systematic lymphadenectomy, followed with adjuvant Concurrent Chemoradiotherapy (CCRT). This retrospective study aimed to compare the efficacy and safety of the two treatment modalities. Methods. 49 stage IB1-IIA2 cervical cancer patients with lymphatic metastasis confirmed by systemic pelvic and para-aortic lymph node dissection from 2007 to 2018 were reviewed. The patients were treated with either primary chemoradiation or radical hysterectomy followed by adjuvant chemoradiation after lymphadenectomy. Survival states and adverse events of the two treatments were compared. Results. Median follow-up time was 45 (range 11-119 months) months. In non-radical surgery group, 1 patient (1/15, 6.7%) relapsed and died, while in radical surgery group, 7 patients (7/27, 25.9%) relapsed and 5 (5/27, 18.5%) died. Significant difference was found in the mean progression-free survival between the two groups, which was 69(95%CI 49.118-88.882) months in non-radical surgery group and 44(95%CI 35.857-52.143) months in radical surgery group (p＜0.01). There was significant difference in three-year progression-free survival(86%vs.71%, p＜0.01). Grade 3-4 toxicity was comparable between the two groups (26.7% vs. 25.9%, p=0.958). Conclusion. For stage IB1-IIA2 cervical cancer patients with positive lymph node, primary chemoradiation after pelvic and para-aortic lymphadenectomy seems to have better survival outcomes compared with radical hysterectomy by laparoscopy plus chemoradiation in the retrospective study with limited cases. Evidence from a randomized controlled study is in need to confirm the optimal treatment for early stage node-positive cervical cancer.

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