Analiza niepowodzeń leczenia chorych na raka płaskonabłonkowego szyjki macicy w stopniu IB–IIA po leczeniu operacyjnym

• Authors: Joanna Terlikiewicz

Title variants

EN

Analysis of treatment failures in stage IB–IIA squamous cell carcinoma of the uterine cervix following surgery

• Languages of publication: EN PL

Abstracts

EN

The outcomes of cervical cancer treatment are strictly associated with such prognostic factors as tumor size, the presence of metastases in pelvic lymph nodes, parametrial invasion and tumor differentiation grade. The aim of the study was to analyze the outcomes of 338 patients with FIGO stage IB–IIA cervical cancer treated with surgery at the Oncology Center in Bydgoszcz, Poland, in 2002–2015. Statistically significant differences in the overall survival rates depending on the size of cervical tumor and FIGO stage as well as in recurrence-free survival rates depending on the presence of pelvic lymph node metastases were observed. In 29.3% of patients treatment failure occurred. In 54.5% of patients from this group nodal recurrence was found and in 26.3% of patients central recurrence was observed. Median time to nodal recurrence was 14 months and median time to local recurrence was 13 months. The results of the analysis confirm the impact of the status of pelvic lymph nodes and the size of the primary tumor on the prognosis for cervical cancer patients.

PL

Wyniki leczenia chorych na raka szyjki macicy są ściśle związane z takimi czynnikami prognostycznymi, jak wielkość guza, obecność przerzutów w węzłach chłonnych miednicy, naciekanie przymacicz i stopień zróżnicowania nowotworowego. Celem pracy była analiza wyników leczenia 338 pacjentek z rakiem szyjki macicy w stopniu FIGO IB–IIA leczonych operacyjnie w Centrum Onkologii w Bydgoszczy w latach 2002–2015. Odnotowano znaczące statystycznie różnice w przeżyciach całkowitych w zależności od wielkości guza szyjki macicy i stopnia FIGO oraz w przeżyciach wolnych od wznowy w zależności od obecności przerzutów w węzłach chłonnych miednicy. U 29,3% chorych wystąpiło niepowodzenie leczenia. U 54,5% pacjentek z tej grupy była to wznowa węzłowa, a u 26,3% – wznowa centralna. Mediana czasu wystąpienia wznowy węzłowej wynosiła 14 miesięcy, wznowy miejscowej – 13 miesięcy. Wyniki przeprowadzonej analizy potwierdzają zależność rokowania chorych na raka szyjki macicy od stanu węzłów chłonnych miednicy i wielkości guza pierwotnego.

Keywords

EN

histerektomia radykalna; rak płaskonabłonkowy szyjki macicy; wyniki leczeniaraka szyjki macicy w stopniu I–IIA; wznowa raka szyjki macicy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Current Gynecologic Oncology
• Year: 2017
• Volume: 15
• Issue: 1
• Pages: 54–67

Contributors

author

Joanna Terlikiewicz

• Oddział Kliniczny Brachyterapii, Centrum Onkologii im. prof. Franciszka Łukaszczyka w Bydgoszczy, Bydgoszcz, Polska

References

• 1. Ferlay J, Soerjomataram I, Dikshit R et al.: Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359–E386.
• 2. Didkowska J, Wojciechowska U, Zatoński W: Nowotwory złośliwe w Polsce w 2011 roku. Krajowy Rejestr Nowotworów, Zakład Epidemiologii i Prewencji Nowotworów, Warszawa 2013. Available from: http://onkologia.org.pl/wp-content/uploads/ COI_Nowotwory2013_web.pdf.
• 3. Samlal RA, van der Velden J, Schilthuis MS et al.: Identification of high-risk groups among node-positive patients with stage IB and IIA cervical carcinoma. Gynecol Oncol 1997; 64: 463–467.
• 4. Kodama J, Seki N, Ojima Y et al.: Prognostic factors in nodepositive patients with stage IB–IIB cervical cancer treated by radical hysterectomy and pelvic lymphadenectomy. Int J Gynaecol Obstet 2006; 93: 130–135.
• 5. Kim SM, Choi HS, Byun JS: Overall 5-year survival rate and prognostic factors in patients with stage IB and IIA cervical cancer treated by radical hysterectomy and pelvic lymph node dissection. Int J Gynecol Cancer 2000; 10: 305–312.
• 6. Viswanathan AN: Uterine cervix: In: Halperin EC, Wazer DE, Perez CA et al.: Perez and Brady’s Principles and Practiceof Radiation Oncology. 6th ed., Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia 2013: 1355–1425.
• 7. Eifel PJ, Berek JS, Markman MA: Cancer of the cervix, vagina, and vulva. In: DeVita VT Jr, Lawrence TS, Rosenberg SA (eds.): Cancer: Principles and Practice of Oncology. 9th ed., Lippincott Williams & Wilkins, Philadelphia 2011: 1311–1344.
• 8. Viswanathan AN, Dizon DS, Gien LT et al.: Cervical cancer. In: Gunderson LL, Tepper JE (eds.): Clinical Radiation Oncology, 4th ed., Elsevier Churchill Livingstone, Philadelphia 2016: 1173–1202.
• 9. Burke TW, Hoskins WJ, Heller PB et al.: Clinical patterns of tumor recurrence after radical hysterectomy in stage IB cervical carcinoma. Obstet Gynecol 1987; 69: 382–385.
• 10. Ciatto S, Pirtoli L, Cionini L: Radiotherapy for postoperative failures of carcinoma of the cervix uteri. Surg Gynecol Obstet 1980; 151: 621–624.
• 11. Takeshima N, Umayahara K, Fujiwara K et al.: Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB–IIA cervical cancer. Gynecol Oncol 2006; 103: 618–622.
• 12. Morice P, Castaigne D, Pautier P et al.: Interest of pelvic and paraaortic lymphadenectomy in patients with stage IB and II cervical carcinoma. Gynecol Oncol 1999; 73: 106–110.
• 13. Ryu SY, Park SI, Nam BH et al.: Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors? Int J Radiat Oncol Biol Phys 2011; 79: 794–799.
• 14. Park JY, Kim DY, Kim JH et al.: Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. Br J Cancer 2010; 102: 1692–1698.
• 15. Denschlag D, Gabriel B, Mueller-Lantzsch C et al.: Evaluation of patients after extraperitoneal lymph node dissection for cervical cancer. Gynecol Oncol 2005; 96: 658–664.
• 16. Rhee ED, Lee JH, Lee KH et al.: Surgical treatment in 561 cases and study on 15,092 cases of carcinoma of the uterine cervix – review of 20 years experience, from 1963 to 1983. Korean J Obstet Gynecol 1984; 27: 1153–1170.
• 17. Lee HP, Park JW, Seo DS et al.: Clinical profile and 5-year survival rate of uterine cervical cancer. Korean J Obstet Gynecol 1993; 36: 854–862.
• 18. Soisson AP, Soper JT, Clarke-Pearson DL et al.: Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol 1990; 37: 390–395.
• 19. Girardi F, Pickel H, Winter R: Pelvic and parametrial lymph nodes in the quality control of the surgical treatment of cervical cancer. Gynecol Oncol 1993; 50: 330–333.
• 20. Delgado G, Bundy B, Zaino R et al.: Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol 1990; 38: 352–357.
• 21. Sevin BU, Lu Y, Bloch DA et al.: Surgically defined prognostic parameters in patients with early cervical carcinoma. A multivariate survival tree analysis. Cancer 1996; 78: 1438–1446.
• 22. Oaknin A, Rubio MJ, Redondo A et al.: SEOM guidelines for cervical cancer. Clin Transl Oncol 2015; 17: 1036–1042.
• 23. Ryu SY, Kim MH, Nam BH et al.: Intermediate-risk grouping of cervical cancer patients treated with radical hysterectomy: a Korean Gynecologic Oncology Group study. Br J Cancer 2014; 110: 278–285.
• 24. Macdonald OK, Chen J, Dodson M et al.: Prognostic significance of histology and positive lymph node involvement following radical hysterectomy in carcinoma of the cervix. Am J Clin Oncol 2009; 32: 411–416.
• 25. Liu Y, Zhao LJ, Li MZ et al.: The number of positive pelvic lymph nodes and multiple groups of pelvic lymph node metastasis influence prognosis in stage IA–IIB cervical squamous cell carcinoma. Chin Med J (Engl) 2015; 128: 2084–2089.
• 26. Takekuma M, Kasamatsu Y, Kado N et al.: Adjuvant chemotherapy versus concurrent chemoradiotherapy for high-risk cervicalcancer after radical hysterectomy and systematic lymphadenectomy. Int J Clin Oncol 2016; 21: 741–747.
• 27. Rudtanasudjatum K, Charoenkwan K, Khunamornpong S et al.: Impact of histology on prognosis of patients with early-stage cervical cancer treated with radical surgery. Int J Gynaecol Obstet 2011; 115: 183–187.
• 28. Park JY, Kim DY, Kim JH et al.: Further stratification of risk groups in patients with lymph node metastasis after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol 2010; 117: 53–58.
• 29. Starzewski J, Sygut J, Malmur M et al.: Recurrence after surgical excision and radiotherapy in cervical cancer stage IB/IIA. Gin Onkol 2007; 5: 125–139.
• 30. Van de Putte G, Lie AK, Vach W et al.: Risk grouping in stage IB squamous cell cervical carcinoma. Gynecol Oncol 2005; 99: 106–112.
• 31. Huang YT, Wang CC, Tsai CS et al.: Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. Int J Radiat Oncol Biol Phys 2012; 84: 420–427.
• 32. Krebs HB, Helmkamp BF, Sevin BU et al.: Recurrent cancer of the cervix following radical hysterectomy and pelvic node dissection. Obstet Gynecol 1982; 59: 422–427.
• 33. Ijaz T, Eifel PJ, Burke T et al.: Radiation therapy of pelvic recurrence after radical hysterectomy for cervical carcinoma. Gynecol Oncol 1998; 70: 241–246.
• 34. Adcock LL, Potish RA, Julian TM et al.: Carcinoma of the cervix, FIGO Stage IB: treatment failures. Gynecol Oncol 1984; 18: 218–225.
• 35. Peters WA 3rd, Liu PY, Barrett RJ 2nd et al.: Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol 2000; 18: 1606–1613.
• 36. Rotman M, Sedlis A, Piedmonte MR et al.: A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2006; 65: 169–176.
• 37. Lee YY, Choi CH, Kim TJ et al.: A comparison of pure adenocarcinoma and squamous cell carcinoma of the cervix after radical hysterectomy in stage IB–IIA. Gynecol Oncol 2011; 120: 439–443.

• Document Type: article