Background: The purpose of this analysis was to identify pathologic risk factors for recurrence and patterns of recurrence in patients with International Federation of Gynecology and Obstetrics Stage IB and IIA cervical carcinoma and negative pelvic lymph nodes after radical hysterectomy.
Methods: During the period 1982-1991, 271 clinically staged patients with Stage IB or IIA cervical carcinoma underwent a Wertheim-Okabayashi radical hysterectomy with pelvic lymph node dissection. The study group was composed of 196 lymph node negative patients. Pathology slides were reviewed and multivariate analysis performed to identify independent prognostic factors.
Results: The recurrence rate in the study group was 7.7%. In multivariate analysis, the following factors were identified as independent risk factors for recurrence: adenocarcinoma (P = 0.003), depth of invasion as a fraction of tumor penetration of the cervical stroma (P = 0.01), and an extensive stromal inflammatory cell infiltrate (P = 0.04). Based on these factors, the following risk groups were identified: a low risk group (N = 140, 5-year disease free interval [DFI] = 97%) and a high risk group (N = 55, 5-year DFI = 81%). An evaluation of the recurrence patterns for these patients showed a predominance of pelvic recurrences.
Conclusions: This study showed that among patients with Stage IB and IIA cervical carcinoma and negative pelvic lymph nodes, a subset with a significant risk for recurrence could be identified. Because the majority of recurrences in the lymph node negative group were pelvic recurrences, the value of adjuvant radiotherapy as a treatment for selected lymph node negative patients should be evaluated in a prospective study.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Phase I-II study of prone hypofractionated accelerated breast and nodal intensity modulated radiation therapy.
Int J Radiat Oncol Biol Phys
January 2025
Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, NY.
Background: In patients with breast cancer, prone radiation therapy (RT) has been shown to reduce heart and lung dose. Though prone positioning is routinely used for whole breast RT, its use when treating the regional lymph nodes (RLNs) is not widespread.
Methods: In this phase I-II trial for stage IB-IIA breast cancer treated with lumpectomy or mastectomy, patients received 40.
Percutaneous Transhepatic Venous Embolization and Portal Vein Stenting for Ectopic Variceal Bleeding at Choledochojejunostomy After Pancreaticoduodenectomy With Portal Vein Stenosis: A Case Report.
Cureus
December 2024
Department of Surgery, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Ectopic varices can result from portal vein stenosis following pancreaticoduodenectomy with concomitant portal vein resection reconstruction, and they can cause gastrointestinal bleeding. Although they can sometimes be fatal, various treatments have been reported. This report describes a case in which a percutaneous transhepatic approach was used to simultaneously perform variceal embolization and portal vein stenting in which a favorable outcome was achieved.
View Article and Find Full Text PDFClinical outcomes of stage IIA/IIB seminoma treated with radiotherapy and chemotherapy: should regional therapy be considered the preferred treatment approach?
Int J Radiat Oncol Biol Phys
January 2025
Radiation Medicine Department, Princess Margaret Cancer Centre, University Health Network; Department of Radiation Oncology, University of Toronto.
Purpose: The optimal management of patients with de novo clinical stage IIA/B (CSIIA/B) or relapsed CSIIA/B (Rel-CSIIA/B) seminoma remains debated due to a lack of randomized evidence. Herein, we sought to evaluate outcomes following radiotherapy and chemotherapy in this setting.
Materials And Methods: A prospectively maintained single-institutional database was retrospectively queried for patients diagnosed between 1995-2016 with de novo or Rel-CSIIA/B.
Maximum Tumor Diameter is Associated with Relapse Risk in Limited-Stage Hodgkin Lymphoma: An International Study.
Blood Adv
January 2025
Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, and Department of Medical Oncology, The Christie Hospital, Manchester, United Kingdom.
Tumour bulk is an established prognostic factor in Hodgkin lymphoma (HL) but most patients with limited-stage (LS) HL do not have 'bulk' by standard binary definitions. In the RAPID trial, maximum tumor diameter (MTD) was associated with risk of relapse for LS-HL patients achieving PET-negativity after ABVD chemotherapy. We aimed to externally validate these findings in the H10 trial.
View Article and Find Full Text PDFIntestinal icrobiota Transplant Prior to llogeneic tem Cell ransplant (MAST) trial: study protocol for a multicentre, double-blinded, placebo-controlled, phase IIa trial.
BMJ Open
December 2024
Centre for Haematology, Department of immunology and inflammation, Faculty of Medicine, Imperial College London, London, UK.
Introduction: Lower diversity of the gut microbiome prior to allogeneic haematopoietic cell transplantation (HCT) correlates with reduced survival after the intervention. Most patients undergoing HCT for a haematological malignancy have previously received intensive chemotherapy, resulting in prolonged neutropenic episodes requiring broad-spectrum antibiotics; use of these has been linked to reduced microbiome diversity. Intestinal microbiota transplant (IMT) is a novel treatment approach that restores this diversity.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!