scholarly journals Prognostic Factors Associated with 5-Year Overall Survival in Cervical Cancer Patients Treated with Radical Hysterectomy Followed by Adjuvant Concurrent Chemoradiation Therapy at a Tertiary Care Center in Eastern Europe

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 570
Author(s):  
Mihai Stanca ◽  
Mihai Emil Căpîlna
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Radical Hysterectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Figo Stage ◽  
Chemoradiation Therapy ◽  
Prognostic Risk Factors ◽  
Concurrent Chemoradiation Therapy

Background: This retrospective observational study aims to assess the 5-year overall survival and the prognostic significance of risk factors of patients who underwent radical hysterectomy followed by adjuvant concurrent chemoradiation therapy (CCRT) for FIGO stage IB1-IIB cervical cancer in a tertiary care center in Eastern Europe. Methods: From January 2010 to February 2019, 222 patients with stage IB1-IIB cervical cancer were treated with radical hysterectomy followed by adjuvant CCRT in our institution. The baseline information consisting of demographic and clinicopathologic data, treatment choices, recurrences, and outcome information was collected and examined. The survival rates were illustrated using Kaplan–Meier curves and prognosis analyses were accomplished using Cox multivariate analyses. Results: The 222 participants had a mean age of 51.2 years (28–76). The median follow-up time was 65.5 months (3–128). Tumor characteristics revealed FIGO stage (IB1 2.3%, IB2 35.1%, IB3 16.7%, IIA1 9%, IIA2 8.6%, IIB 28.4%) and the most encountered histologic cell type was squamous cell carcinoma (80.06%) followed by adenocarcinoma (11.3%). At the time of examination, 157 patients (70.07%) were alive, of which 135 (61%) were alive free of disease and 22 (9%) were alive with disease. The multivariate Cox regression analysis acknowledged stage IIB, parametrial involvement, and the presence of lymph node metastases as independent prognostic risk factors, significantly worsening the oncologic outcomes influencing the survival with a P-value of 0.076, 0.0001, and 0.008, respectively. The 5-year overall survival was 69.9%. Conclusions: Altogether, the study enhances the significance of prognostic risk factors on the 5-year overall survival of patients who underwent radical hysterectomy followed by adjuvant CCRT for FIGO stages IB1-IIB cervical cancer, allowing comparisons with other regions.

Weekly Cisplatin Therapy Compared With Triweekly Combination Chemotherapy as Concurrent Adjuvant Chemoradiation Therapy After Radical Hysterectomy for Cervical Cancer

2011 ◽  
Vol 21 (1) ◽  
pp. 128-136 ◽  
Author(s):  
Hae Nam Lee ◽  
Keun Ho Lee ◽  
Dae Woo Lee ◽  
Yong Seok Lee ◽  
Eun Kyung Park ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Combination Chemotherapy ◽  
Radical Hysterectomy ◽  
Radical Surgery ◽  
Disease Free Survival ◽  
Chemoradiation Therapy ◽  
Adjuvant Chemoradiation ◽  
Chemotherapy Group ◽  
Weekly Cisplatin

Objective:To evaluate whether the use of triweekly combination chemotherapy together with radiation exerts a more beneficial systemic effect than weekly cisplatin chemoradiation in patients with cervical cancer after radical surgery.Methods:We retrospectively analyzed patients with stage IB1 to stage IIB cervical cancer who had undergone radical hysterectomy with pelvic lymph node dissection, followed by concurrent adjuvant chemoradiation therapy. The patients were divided into 2 groups: the triweekly combination chemotherapy group and the weekly cisplatin chemotherapy group. We evaluated the survival and adverse effects of the 2 groups.Results:In total, 201 patients were included. The mean duration of follow-up was 52.2 months. Of the 201 patients, 130 received triweekly combination chemotherapy, and 71 patients received weekly cisplatin chemotherapy as an adjuvant treatment. The 5-year disease-free survival was 82.2% for patients treated with weekly cisplatin chemotherapy and 74.3% for those treated with triweekly combination chemotherapy (P= 0.3929). The 5-year overall survival was 81.4% and 79.3% for the same treatment groups, respectively (P= 0.9833). The overall survival of the patients with stage IIB cervical cancer was marginally higher in the triweekly combination chemotherapy group than in the weekly cisplatin group (P= 0.0582). Leukopenia, neutropenia, thrombocytopenia, anemia, and hepatopathy were significantly more common in the triweekly combination chemotherapy group.Conclusions:The weekly cisplatin chemotherapy group experienced the same therapeutic effect as the triweekly combination chemotherapy group but with less toxicity. Therefore, weekly cisplatin chemotherapy is considered the more useful concurrent adjuvant chemoradiation regimen after radical surgery.

scholarly journals Pleural effusion as a novel prognostic factor in metastatic thyroid carcinoma

2020 ◽  
Vol 9 (8) ◽  
pp. 812-823
Author(s):  
David T Broome ◽  
Gauri B Gadre ◽  
Ehsan Fayazzadeh ◽  
James F Bena ◽  
Christian Nasr
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Thyroid Carcinoma ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Resection ◽  
Distant Metastases ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Prognostic Risk Factors

Objective: To identify novel prognostic risk factors and compare them with other known prognostic risk factors in follicular-cell-derived thyroid carcinoma (FDTC) with distant metastases. Methods: A retrospective review was conducted of adult patients with metastatic FDTC seen at a tertiary care center between January 1990 and December 2010. A 15-year Kaplan–Meier survival estimate was created for overall survival (OS) and cancer-specific survival (CSS). Hazard ratios (HR) and P values from Cox proportional hazard models were used with a 95% CI. Results: There were 143 patients (60.1% male, 39.9% female), of whom 104 (72.7%) patients had papillary, 30 (21.0%) had follicular, 5 (3.5%) had poorly differentiated, and 4 (2.8%) had Hürthle cell cancers. Median length of follow-up was 80.0 months (range 1.0–564.0). The 15-year mortality rate was 32.2% and cancer-specific mortality was 25.2%, with OS and CSS having the same risk factors. Lung was the most common site of metastases in 53 patients (37.1%), and patients with pleural effusions had significantly lower CSS (HR = 5.21, CI = 1.79–15.12). Additional risk factors for a decreased CSS included: older age upon diagnosis (>45 years, HR = 4.15, CI = 1.43–12.02), multiple metastatic locations (HR = 3.75, CI = 1.32–10.67), and incomplete/unknown tumor resection (HR = 2.35, CI = 1.18–4.67). Conclusion: This study is the first to demonstrate that pleural effusion is a poor prognostic sign in patients with FDTC with distant metastases and compare this risk with other accepted prognostic variables.

A randomized phase III trial of adjuvant chemotherapy versus concurrent chemoradiotherapy for postoperative cervical cancer: Japanese Gynecologic Oncology Group study (JGOG1082)

2021 ◽  
pp. ijgc-2020-002344
Author(s):  
Akiko Furusawa ◽  
Munetaka Takekuma ◽  
Keita Mori ◽  
Tomoka Usami ◽  
Eiji Kondo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Primary Endpoint ◽  
Radical Hysterectomy ◽  
Concurrent Chemoradiotherapy ◽  
High Risk Factors

BackgroundThe standard treatment for stage IB–IIB cervical cancer is radiotherapy or radical hysterectomy; after radical hysterectomy, adjuvant concurrent chemoradiotherapy is recommended for patients with high risk factors. However, adjuvant concurrent chemoradiotherapy can cause severe gastrointestinal and urinary toxicity.Primary ObjectiveTo assess whether postoperative adjuvant chemotherapy is not inferior to adjuvant concurrent chemoradiotherapy for overall survival in patients with high risk cervical cancer.Study HypothesisAdjuvant chemotherapy is not inferior to adjuvant concurrent chemoradiotherapy for overall survival and will reduce severe toxicities.Trial DesignPatients with high risk factors after radical hysterectomy will be randomized 1:1 to receive adjuvant concurrent chemoradiotherapy or adjuvant chemotherapy. Treatment will be started within 6 weeks of surgery. The concurrent chemoradiotherapy group will receive whole pelvis irradiation (50.4 Gy) and cisplatin (40 mg/m2/week). The chemotherapy group will receive paclitaxel (175 mg/m2) plus cisplatin (50 mg/m2) or carboplatin (AUC=6) every 3 weeks for six cycles.Major Inclusion/Exclusion CriteriaPatients with high risk stage IB–IIB cervical cancer (squamous cell carcinoma, adenocarcinoma, and adenosquamous cell carcinoma) who underwent radical hysterectomy are eligible for the study. High risk is defined as the presence of pelvic lymph node metastasis and/or parametrial invasion.Primary EndpointThe primary endpoint is overall survival.Sample Size250 patients in total are required.Estimated Dates for Completing AccrualThis study began in November 2019, and 250 patients will be accrued within 5 years.Trial Registration NumberThe study has been registered with the Japan Registry of Clinical Trials (jRCTs041190042).

scholarly journals Risk Factors for Pelvic Lymph Node Metastasis and Recurrence in Patients Undergoing Radical Hysterectomy for Cervical Cancer

2021 ◽  
Author(s):  
Xinmei Wang ◽  
Hongyuan Zhang ◽  
Juan Xu ◽  
Pengpeng Qu
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Figo Stage ◽  
Pelvic Lymphadenectomy ◽  
Tumor Diameter ◽  
Preoperative Hemoglobin ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis ◽  
Preoperative Hemoglobin Level

Abstract Background: Radical hysterectomy and bilateral pelvic lymphadenectomy are standard treatments for early-stage cervical cancer. Pelvic lymph node metastasis (PLNM) is one of the critical factors affecting the postoperative prognosis of patients. Therefore, the identification of preoperative risk factors for PLNM will minimize its occurrence and improve prognosis. The purpose of this study was to investigate the risk factors for PLNM and its recurrence in patients undergoing radical hysterectomy for cervical cancer.Methods: Medical records of 245 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for the International Federation of Gynaecology and Obstetrics (FIGO) stage IA-IIA cervical cancer between January 2010 and December 2015 at our hospital were reviewed. Age, FIGO stage, preoperative hemoglobin level, depth of stromal invasion, lymphovascular space invasion (LVSI), human papillomavirus(HPV) infection, parametrial infiltration, tumor diameter, number of lymphadenectomies, and pathological type were retrospectively analyzed. All patients were followed up for 5–10 years.Results: Among the 245 patients, 185 (75.51%) had no PLNM, whereas 60 (24.49%) had PLNM. Preoperative hemoglobin level, FIGO stage, LVSI, parametrial infiltration, and tumor diameter differed significantly between the two groups (P<0.05). Multivariate analysis revealed preoperative hemoglobin <110 g/L, FIGO stage II, LVSI, parametrial infiltration, and tumor diameter ≥4 cm as significant risk factors for PLNM and recurrence of cervical cancer after surgery (P<0.05). PLNM was identified as the independent risk factor for recurrence in patients with cervical cancer after surgery (P<0.05).Conclusions: PLNM is an important prognostic indicator for the clinical treatment of cervical cancer. Patients at a high risk of recurrence, especially PLNM patients, should be followed up closely after surgery to ensure the timely detection of recurrence and treatment.

Study of risk factors of eclampsia in a tertiary care center

2019 ◽  
Vol 12 (2) ◽  
pp. 31-35
Author(s):  
Padma Chandavathu ◽  
◽  
Akurathi Krishna Rao ◽  
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center
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