Cancer Research and Treatment

Special Article

Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023: EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh; Received March 31, 2024 Accepted August 1, 2024 Published online August 2, 2024; DOI: https://doi.org/10.4143/crt.2024.325 [Epub ahead of print]

Abstract PDF Supplementary Material: Purpose
This study aimed to report the overall national trends in the rates of cancer screening based on recommendations and provide insights into the changing trends of these rates across different demographics.
Materials and Methods
This study used data from the Korean National Cancer Screening Survey (KNCSS), which surveys nationwide cancer-screening rates and includes 4,500 individuals meeting the Korean National Cancer Screening Program (NCSP) protocol age criteria. Cancer-screening rates were assessed using structured questionnaires; yearly trends were analyzed for both lifetime cancer-screening rates and rates of screening based on recommendations, and subgroup analyses were performed based on age and sex.
Results
The rates of cancer screening based on recommendations showed significant increments: the stomach cancer-screening rate increased from 39.2% in 2004 to 77.5% in 2023 (3.50% per year), the liver cancer-screening rate increased from 20.0% to 48.8% (4.30% per year), and the colorectal cancer, increased from 19.9% to 70.7% (5.15% per year). The breast cancer-screening rate increased from 33.2% to 72.7% (2.88% per year), and the cervical cancer, increased from 58.3% to 70.2% (1.08% per year). Despite some differences, particularly in relation to sociodemographic factors, screening rates increased significantly for all cancer types.
Conclusion
Cancer-screening rates in Korea increased consistently from 2004 to 2023, demonstrating the effectiveness of the national cancer-screening program. However, the increments in breast, cervical and lung cancer-screening rates were relatively lower, indicating the need for additional efforts and strategies.

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Original Article

Gynecologic cancer

Predicted Cervical Cancer Prevention: Impact of National HPV Vaccination Program on Young Women in South Korea: Kyeongmin Kwak, Seung-sik Hwang; Cancer Res Treat. 2024;56(3):898-908. Published online January 15, 2024; DOI: https://doi.org/10.4143/crt.2023.981

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to evaluate the effectiveness of the national human papillomavirus (HPV) vaccination program of South Korea among its entire female population, particularly among younger age groups.
Materials and Methods
We first predicted the incidence of cervical cancer over the next 20 years (2021-2040) using the Nordpred package based on Møller’s age-period-cohort model under several scenarios for the national HPV vaccination program. We calculated the potential impact fractions and proportional differences under the current national vaccination programs, and alternative scenarios using the no-vaccination assumption as a reference.
Results
We estimated that the current national vaccination program would prevent 4.13% of cervical cancer cases and reduce the age-standardized incidence rate (ASR) by 8.79% in the overall population by 2036-2040. Under the alternative scenario of implementing the nine-valent vaccine, 5.13% of cervical cancer cases could be prevented and the ASR reduced by 10.93% during the same period. In another scenario, expanding the vaccination age to 9-17 years could prevent 10.19% of cervical cancer cases, with the ASR reduced by 18.57% during the same period. When restricted to ages < 40 years, the prevention effect was remarkably greater. We predict that the current national HPV program will reduce its incidence by more than 30% between 2036 and 2040 in women aged < 40 years.
Conclusion
The effectiveness of the vaccination program in reducing the incidence of cervical cancer was confirmed, with a considerable impact anticipated in younger age groups.

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Review Article

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review: Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2024;56(1):1-17. Published online August 30, 2023; DOI: https://doi.org/10.4143/crt.2023.562

Abstract PDF PubReader ePub

Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

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Long term clinical outcomes of cervical cancer patients who were recommended surgery but did not undergo it: A SEER database study
Zhaoming Zhang, Hongfu Zhao, Guanghui Cheng
European Journal of Surgical Oncology.2024; 50(10): 108572. CrossRef
Treatment of secondary uterine malignancy following radiotherapy for cervical cancer: a study based on the SEER database
Xiaojing Tong, Yunyun Xiao, Haozhen Li, Hang Zhang, Jiawen Li
BMC Women's Health.2024;[Epub] CrossRef

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Original Articles

Gynecologic cancer

Plasma Cell-Free DNA in Uterine Cervical Cancer: Therapeutic Monitoring and Prognostic Values after Radical Radiotherapy: Jae Sik Kim, Sunah Yang, Kyeonghun Jeong, Dong-Yun Kim, Kwangsoo Kim, Hyun-Cheol Kang; Cancer Res Treat. 2023;55(2):659-670. Published online December 12, 2022; DOI: https://doi.org/10.4143/crt.2022.1440

Abstract PDF Supplementary Material PubReader ePub

Purpose
In the present study, we aimed to establish a liquid biopsy-based monitoring method using peripheral blood cell-free DNA (cfDNA) for patients with cervical cancer who underwent radical radiotherapy (RT).
Materials and Methods
Twenty-five patients with cervical cancer were prospectively recruited and treated with external beam RT and brachytherapy. In all patients, except one, chemotherapy was administered concurrently during RT. Whole peripheral blood samples were obtained at least twice from each patient. We performed next-generation sequencing (NGS) for the target-captured libraries (67 oncogenes and human papillomavirus [HPV] type 16/18) using 64 plasma cfDNA samples from the 25 participants. The ratio of HPV cfDNA and the variant allele frequency (VAF) in cfDNA was calculated, and their dynamic changes were monitored. The median follow-up duration was 25.4 months.
Results
In total, we identified 21,866 cfDNA variants. ARID1A and frameshift variants occupied the largest portion of altered genes and HIGH-grade variant types, respectively. In most cases, tumor shrinkage was followed by a decrease in the HPV ratio; however, an increase in HPV ratio indicated distant metastasis, despite the reduced tumor size. The initial HPV ratio reflecting the tumor burden was likely associated with treatment outcomes (p = 0.16). We did not determine a role for serial changes in the VAF in cfDNA.
Conclusion
Our findings suggest that the HPV cfDNA ratio, calculated after targeted NGS, may be valuable for monitoring and predicting treatment responses. Accordingly, further validation of these findings is warranted.

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Circulating cell-free DNA as a diagnostic and prognostic marker for cervical cancer
Preetiparna Parida, Gayathri Baburaj, Mahadev Rao, Shirley Lewis, Rama Rao Damerla
International Journal of Gynecologic Cancer.2024; 34(2): 307. CrossRef
Prognostic value of circulating short-length DNA fragments in unresected glioblastoma patients
Arthur Daban, Ludivine Beaussire-Trouvay, Émilie Lévêque, Cristina Alexandru, Isabelle Tennevet, Olivier Langlois, Ovidiu Veresezan, Florent Marguet, Florian Clatot, Frédéric Di Fiore, Nasrin Sarafan-Vasseur, Maxime Fontanilles
Translational Oncology.2024; 42: 101897. CrossRef
Cervical Cancer Genetic Profile through Circulating Tumor DNA: What Can We Learn from Blood?
Sevastiani Antonouli, Valentina Di Nisio, Nikoletta Daponte, Athina-Ioanna Daponte, Alexandros Daponte
Biomolecules.2024; 14(7): 825. CrossRef
High throughput sequencing technology and its clinical application in circulating tumor DNA detection in patients with tumors.
Chonghe Xu, Dangui Zhou, Mei Zhu
Investigación Clínica.2024; 65(4): 476. CrossRef

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Image-Guided Versus Conventional Brachytherapy for Locally Advanced Cervical Cancer: Experience of Single Institution with the Same Practitioner and Time Period: Tae Hoon Lee, Kyung Su Kim, Hak Jae Kim, Chang Heon Choi, Seonghee Kang, Keun-Yong Eom, Chan Woo Wee, Yong Sang Song, Noh Hyun Park, Jae-Weon Kim, Hyun Hoon Chung, Hee Seung Kim, Maria Lee, Hyun-Cheol Kang; Cancer Res Treat. 2023;55(1):258-269. Published online August 10, 2022; DOI: https://doi.org/10.4143/crt.2022.418

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to compare treatment outcomes and toxicity profile between imaged-guided brachytherapy (IGBT) versus conventional brachytherapy (CBT) performed by the same practitioner during the same time period.
Materials and Methods
Medical records of 104 eligible patients who underwent brachytherapy for locally advanced cervical cancer were retrospectively reviewed. Fifty patients (48.1%) underwent IGBT, and 54 (51.9%) patients underwent CBT. All patients underwent concurrent chemoradiation with cisplatin. High-dose-rate intracavitary brachytherapy with dose prescription of 25-30 Gy in 4-6 fractions was performed for all patients. Late lower gastrointestinal (GI) and urinary toxicities occurred more than 3 months after the end of brachytherapy were included for comparative and dosimetric analyses.
Results
The median follow-up period was 18.33 months (range, 3.25 to 38.43 months). There were no differences in oncologic outcomes between the two groups. The IGBT group had lower rate of actuarial grade ≥ 3 toxicity than the CBT group (2-year, 4.5% vs. 25.7%; p=0.030). Cumulative equieffective D2cc of sigmoid colon was significantly correlated with grade ≥ 2 lower GI toxicity (p=0.033), while equieffective D2cc of rectum (p=0.055) and bladder (p=0.069) showed marginal significance with corresponding grade ≥ 2 toxicities in the IGBT group. Half of grade ≥ 3 lower GI toxicities impacted GI tract above the rectum. Optimal thresholds of cumulative D2cc of sigmoid colon and rectum were 69.7 Gy and 70.8 Gy, respectively, for grade ≥ 2 lower GI toxicity.
Conclusion
IGBT showed superior toxicity profile to CBT. Evaluating the dose to the GI tract above rectum by IGBT might prevent some toxicities.

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Cisplatin

Reactions Weekly.2023; 1947(1): 125. CrossRef
A Mixed Methods Study to Implement the Synergy Tool and Evaluate Its Impact on Long-Term Care Residents
Farinaz Havaei, Francis Kobekyaa, Andy Ma, Maura MacPhee, Wei Zhang, Megan Kaulius, Bahar Ahmadi, Sheila Boamah, Adam Easterbrook, Amy Salmon
Healthcare.2023; 11(15): 2187. CrossRef

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Genomic Correlates of Unfavorable Outcome in Locally Advanced Cervical Cancer Treated with Neoadjuvant Chemoradiation: Yuchun Wei, Chuqing Wei, Liang Chen, Ning Liu, Qiuxiang Ou, Jiani C. Yin, Jiaohui Pang, Zhenhao Fang, Xue Wu, Xiaonan Wang, Dianbin Mu, Yang Shao, Jinming Yu, Shuanghu Yuan; Cancer Res Treat. 2022;54(4):1209-1218. Published online January 17, 2022; DOI: https://doi.org/10.4143/crt.2021.963

Abstract PDF Supplementary Material PubReader ePub

Purpose
Neoadjuvant therapy modality can increase the operability rate and mitigate pathological risks in locally advanced cervical cancer, but treatment response varies widely. It remains unclear whether genetic alterations correlate with the response to neoadjuvant therapy and disease-free survival (DFS) in locally advanced cervical cancer.
Materials and Methods
A total of 62 locally advanced cervical cancer (stage IB-IIA) patients who received neoadjuvant chemoradiation plus radical hysterectomy were retrospectively analyzed. Patients’ tumor biopsy samples were comprehensively profiled using targeted next generation sequencing. Pathologic response to neoadjuvant treatment and DFS were evaluated against the association with genomic traits.
Results
Genetic alterations of PIK3CA were most frequent (37%), comparable to that of Caucasian populations from The Cancer Genome Atlas. The mutation frequency of genes including TERT, POLD1, NOS2, and FGFR3 was significantly higher in Chinese patients whereas RPTOR, EGFR, and TP53 were underrepresented in comparison to Caucasians. Germline mutations were identified in 21% (13/62) of the cohort and more than half (57%) had mutations in DNA damage repair genes, including BRCA1/2, TP53 and PALB2. Importantly, high tumor mutation burden, TP53 polymorphism (rs1042522), and KEAP1 mutations were found to be associated with poor pathologic response to neoadjuvant chemoradiation treatment. KEAP1 mutations, PIK3CA-SOX2 co-amplification, TERC copy number gain, and TYMS polymorphism correlated with an increased risk of disease relapse.
Conclusion
We report the genomic profile of locally advanced cervical cancer patients and the distinction between Asian and Caucasian cohorts. Our findings highlight genomic traits associated with unfavorable neoadjuvant chemoradiation response and a higher risk of early disease recurrence.

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Comprehensive characterization of PKHD1 mutation in human colon cancer
Lu Han, Fangming Gong, Xuxiaochen Wu, Wanxiangfu Tang, Hua Bao, Yue Wang, Daizhenru Wang, Yulan Sun, Peng Li
Cancer Medicine.2024;[Epub] CrossRef
PBRM1 presents a potential ctDNA marker to monitor response to neoadjuvant chemotherapy in cervical cancer
Wenhan Li, Yuhui Huang, Man Xiao, Jing Zhao, Shi Du, Zehua Wang, Sha Hu, Lu Yang, Jing Cai
iScience.2024; 27(3): 109160. CrossRef
Comprehensive genomic profiling of pulmonary spindle cell carcinoma using tissue and plasma samples: insights from a real‐world cohort analysis
Yi Sun, Shilei Qin, Song Wang, Jiaohui Pang, Qiuxiang Ou, Weiquan Liang, Hai Zhong
The Journal of Pathology: Clinical Research.2024;[Epub] CrossRef
PD-1 inhibitor plus concurrent chemoradiotherapy for high-risk locally advanced cervical cancer
Cong Wang, Lijun Liu, Xia Li, Jia Lei, Yiqian Li, Zhibo Shen, Huirong Shi, Yan Cheng
Future Oncology.2024; 20(20): 1415. CrossRef
A biomarker exploration in small-cell lung cancer for brain metastases risk and prophylactic cranial irradiation therapy efficacy
Li Li, Ning Liu, Tao Zhou, Xueting Qin, Xiaoyu Song, Song Wang, Jiaohui Pang, Qiuxiang Ou, Yong Wang, Dexian Zhang, Jiaran Li, Fuhao Xu, Shuming Shi, Jinming Yu, Shuanghu Yuan
Lung Cancer.2024; 196: 107959. CrossRef
Prospects of POLD1 in Human Cancers: A Review
Michał Gola, Przemysław Stefaniak, Janusz Godlewski, Barbara Jereczek-Fossa, Anna Starzyńska
Cancers.2023; 15(6): 1905. CrossRef
Copy-number-gain of telomerase reverse transcriptase (hTERT) is associated with an unfavorable prognosis in esophageal adenocarcinoma
Su Ir Lyu, Felix C. Popp, Adrian Georg Simon, Anne Maria Schultheis, Thomas Zander, Caroline Fretter, Wolfgang Schröder, Christiane J. Bruns, Thomas Schmidt, Alexander Quaas, Karl Knipper
Scientific Reports.2023;[Epub] CrossRef

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Gynecologic Cancer

Cervical Cancer in Women with Normal Papanicolaou Tests: A Korean Nationwide Cohort Study: Miseon Kim, Hyeongsu Kim, Dong Hoon Suh, Yong Beom Kim; Cancer Res Treat. 2021;53(3):813-818. Published online December 10, 2020; DOI: https://doi.org/10.4143/crt.2020.826

Abstract PDF PubReader ePub

Purpose
This study aimed to evaluate the risk of cervical cancer diagnosed within 1 year after the last of multiple consecutive normal Papanicolau (Pap) tests.
Materials and Methods
The database of the National Health Insurance Service was used. We obtained Pap test data for 11,052,116 women aged 30-79 between 2007-2012. The cumulative incidence rates and 5-year overall survival rates of cervical cancer diagnosed within 1 year after the last normal Pap test were compared between women with one (N1), two (N2), and three consecutive normal Pap tests (N3). Women who did not receive a Pap test during the study period were assigned in the N0 group.
Results
The 1-year cumulative incidence rates of cervical cancer were 58.9, 24.6, 20.3, and 14.2 per 105 in the N0, N1, N2, and N3 groups, respectively. Compared to the N1 group, the risk of cervical cancer diagnosed within 1 year of the last normal Pap test decreased by 17% (relative risk [RR], 0.825; 95% confidence interval [CI], 0.716 to 0.951) in the N2 group and 42% (RR, 0.578; 95% CI, 0.480 to 0.695) in the N3 group. However, the 5-year survival rate in women diagnosed with cervical cancer within 1 year of the last normal Pap test in the N3 group was not higher than that of the N1 group (79.6% vs. 81.3%, p=0.706).
Conclusion
As normal Pap tests are consecutively repeated, cervical cancer risk significantly decreases. However, previous consecutive normal Pap tests are not associated with improving survival outcomes in women shortly diagnosed with cervical cancer after the last normal Pap test.

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Socioeconomic disparities in Papanicolaou test utilization in Western Iran
Bahare Safari-Faramani, Roya Safari-Faramani, Farid Najafi, Davoud Khorasani Zavareh, Ali Kazemi Karyani, Mitra Darbandi
BMC Public Health.2024;[Epub] CrossRef
Frequency shift Raman-based sensing of serum MicroRNA for ultrasensitive cervical cancer diagnosis
Jie Wang, Shenxiang Liu, Benfei Wei, Yulong Liu
Photodiagnosis and Photodynamic Therapy.2024; 46: 104105. CrossRef
Elevated risk of cervical cancer in elderly women with incident ulcerative colitis in South Korea
Jihoon Kim, Halim Jo, Min Chul Ha, Hyunil Kim, Jung Kuk Lee, Jae Hun Han, San-Hui Lee, Dae Ryong Kang, Su Young Kim, Hyun-Soo Kim, Hee Man Kim
Scientific Reports.2023;[Epub] CrossRef

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Early Metabolic Response Assessed Using ¹⁸F-FDG-PET/CT for Image-Guided Intracavitary Brachytherapy Can Better Predict Treatment Outcomes in Patients with Cervical Cancer: Nalee Kim, Won Park, Won Kyung Cho, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee, Tae-Joong Kim, Chel Hun Choi, Yoo-Young Lee, Young Seok Cho; Cancer Res Treat. 2021;53(3):803-812. Published online December 9, 2020; DOI: https://doi.org/10.4143/crt.2020.1251

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify the prognostic value of early metabolic response assessed using ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiation therapy (RT) for cervical cancer.
Materials and Methods
We identified 116 patients treated with definitive RT, including FDG-PET/CT–guided intracavitary brachytherapy, between 2009 and 2018. We calculated parameters including maximum (SUV_max) and mean standardized uptake values (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for baseline FDG-PET/CT (PET_base) and image-guided brachytherapy planning FDG-PET/CT (PET_IGBT). Multivariable analyses of disease-free survival (DFS) and overall survival (OS) were performed.
Results
We observed a time-dependent decrease in PET parameters between PET_base and PET_IGBT; ΔSUV_max, ΔSUV_mean, ΔMTV, and ΔTLG were 65%, 61%, 78%, and 93%, respectively. With a median follow-up of 59.5 months, the 5-year DFS and OS rates were 66% and 79%, respectively. Multivariable analysis demonstrated that ΔSUV_max ≥ 50% was associated with favorable DFS (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.14 to 5.77) and OS (HR, 5.14; 95% CI, 1.55 to 17.01). Patients with ΔSUV_max ≥ 50% (n=87) showed better DFS and OS than those with ΔSUV_max < 50% (n=29) (DFS, 76% vs. 35%, p < 0.001; OS, 90% vs. 41%, p < 0.001, respectively). Adenocarcinoma was frequently observed in ΔSUV_max < 50% compared to ΔSUV_max ≥ 50% (27.6% vs. 10.3%, p=0.003). In addition, models incorporating metabolic parameters showed improved accuracy for predicting DFS (p=0.012) and OS (p=0.004) than models with clinicopathologic factors.
Conclusion
Changes in metabolic parameters, especially those in SUV_max by > 50%, can help improve survival outcome predictions for patients with cervical cancer treated with definitive RT.

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Personalized strategies for brachytherapy of cervix cancer
Guillaume Camprodon, Alexandra Gabro, Zineb El Ayachi, Supriya Chopra, Remi Nout, Philippe Maingon, Cyrus Chargari
Cancer/Radiothérapie.2024; 28(6-7): 610. CrossRef
Brachytherapy for cervical cancer: from intracavitary to interstitial technique
Xiaojing Yang, Hanru Ren, Zhen Li, Jie Fu
Frontiers in Oncology.2024;[Epub] CrossRef
Application of three-dimensional multi-imaging combination in brachytherapy of cervical cancer
Zhaoming Zhang, Ning Zhang, Guanghui Cheng
La radiologia medica.2023; 128(5): 588. CrossRef
MRI- and PET-Based Assessment of Radiological and Clinical Factors Associated With Cervical Cancer Response to External Beam Radiation Therapy
Arun G Paul, Steven Miller, Lance K Heilbrun, Daryn W Smith
Cureus.2022;[Epub] CrossRef

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General

Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004–2018: Seri Hong, Yun Yeong Lee, Jaeho Lee, Yeol Kim, Kui Son Choi, Jae Kwan Jun, Mina Suh; Cancer Res Treat. 2021;53(2):330-338. Published online October 20, 2020; DOI: https://doi.org/10.4143/crt.2020.263

Abstract PDF Supplementary Material PubReader ePub

Purpose
The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004–2018.
Materials and Methods
KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40–74 years and women aged 20–74 years with no cancer histories.
Results
Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively.
Conclusion
Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

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Gynecologic cancer

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer: Lan Ying Li, Lan Ying Wen, Sun Hee Park, Eun Ji Nam, Jung Yun Lee, Sunghoon Kim, Young Tae Kim, Sang Wun Kim; Cancer Res Treat. 2021;53(1):243-251. Published online October 12, 2020; DOI: https://doi.org/10.4143/crt.2020.063

Abstract PDF Supplementary Material PubReader ePub

Purpose
The objective of this study was to define the learning curve required to attain satisfactory oncologic outcomes of cervical cancer patients who were undergoing open or minimally invasive surgery for radical hysterectomy, and to analyze the correlation between the learning curve and tumor size.
Materials and Methods
Cervical cancer patients (stage IA-IIA) who underwent open radical hysterectomy (n=280) or minimal invasive radical hysterectomy (n=282) were retrospectively reviewed. The learning curve was evaluated using cumulative sum of 5-year recurrence rates. Survival outcomes were analyzed based on the operation period (“learning period,” P1 vs. “skilled period,” P2), operation mode, and tumor size.
Results
The 5-year disease-free and overall survival rates between open and minimally invasive groups were 91.8% and 89.0% (p=0.098) and 96.1% and 97.2% (p=0.944), respectively. The number of surgeries for learning period was 30 and 60 in open and minimally invasive group, respectively. P2 had better 5-year disease-free survival than P1 after adjusting for risk factors (hazard ratio, 0.392; 95% confidence interval, 0.210 to 0.734; p=0.003). All patients with tumors < 2 cm had similar 5-year disease-free survival regardless of operation mode or learning curve. Minimally invasive group presented lower survival rates than open group when tumors ≥ 2 cm in P2. Preoperative conization improved disease-free survival in patients with tumors ≥ 2 cm, especially in minimally invasive group.
Conclusion
Minimally invasive radical hysterectomy required more cases than open group to achieve acceptable 5-year disease-free survival. When tumors ≥ 2 cm, the surgeon’s proficiency affected survival outcomes in both groups.

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Radical Hysterectomy With Preoperative Conization in Early-Stage Cervical Cancer: A Systematic Review and Pairwise and Network Meta-Analysis
Xinbin Zhu, Lele Ye, Yunfeng Fu, Bingbing You, Weiguo Lu
Journal of Minimally Invasive Gynecology.2024; 31(3): 193. CrossRef
Minimally invasive radical hysterectomy and the importance of avoiding cancer cell spillage for early-stage cervical cancer: a narrative review
Atsushi Fusegi, Hiroyuki Kanao, Shiho Tsumura, Atsushi Murakami, Akiko Abe, Yoichi Aoki, Hidetaka Nomura
Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy
Nicolò Bizzarri, Lukáš Dostálek, Luc R. C. W. van Lonkhuijzen, Diana Giannarelli, Aldo Lopez, Henrik Falconer, Denis Querleu, Ali Ayhan, Sarah H. Kim, David Isla Ortiz, Jaroslav Klat, Fabio Landoni, Juliana Rodriguez, Ranjit Manchanda, Jan Kosťun, Pedro T
Obstetrics & Gynecology.2023; 141(1): 207. CrossRef
Learning Laparoscopic Radical Hysterectomy: Are We Facing an Emerging Situation?
Graziella Moufawad, Antonio Simone Laganà, Nassir Habib, Vito Chiantera, Andrea Giannini, Federico Ferrari, Amerigo Vitagliano, Luigi Della Corte, Giuseppe Bifulco, Zaki Sleiman
International Journal of Environmental Research and Public Health.2023; 20(3): 2053. CrossRef
Breast Reconstruction with DIEP Flap: The Learning Curve at a Breast Reconstruction Center and a Single-Surgeon Study
Charalampos Varnava, Philipp Wiebringhaus, Tobias Hirsch, Alexander Dermietzel, Maximilian Kueckelhaus
Journal of Clinical Medicine.2023; 12(8): 2894. CrossRef
A meta-analysis of survival after minimally invasive radical hysterectomy versus abdominal radical hysterectomy in cervical cancer: center-associated factors matter
Si Sun, Jing Cai, Ruixie Li, Yujia Wang, Jing Zhao, Yuhui Huang, Linjuan Xu, Qiang Yang, Zehua Wang
Archives of Gynecology and Obstetrics.2022; 306(3): 623. CrossRef
Comparison of Minimally Invasive Versus Abdominal Radical Hysterectomy for Early-Stage Cervical Cancer: An Updated Meta-Analysis
Mengting Zhang, Wei Dai, Yuexiu Si, Yetan Shi, Xiangyuan Li, Ke Jiang, Jingyi Shen, Liying Ying
Frontiers in Oncology.2022;[Epub] CrossRef
Assessment of ESGO Quality Indicators in Cervical Cancer Surgery: A Real-World Study in a High-Volume Chinese Hospital
Yan Ding, Xuyin Zhang, Junjun Qiu, Jianfeng Zhang, Keqin Hua
Frontiers in Oncology.2022;[Epub] CrossRef
Trends in Surgical Morbidity and Survival Outcomes for Radical Hysterectomy in West China: An 11-Year Retrospective Cohort Study
Huining Jing, Ying Yang, Yinxia Liu, Peijun Zou, Zhengyu Li
Frontiers in Oncology.2022;[Epub] CrossRef
Comparison of Prognosis between Minimally Invasive and Abdominal Radical Hysterectomy for Patients with Early-Stage Cervical Cancer
Tomohito Tanaka, Shoko Ueda, Shunsuke Miyamoto, Sousuke Hashida, Shinichi Terada, Hiromi Konishi, Yuhei Kogata, Kohei Taniguchi, Kazumasa Komura, Masahide Ohmichi
Current Oncology.2022; 29(4): 2272. CrossRef
Open versus minimally invasive radical hysterectomy for early cervical cancer: A two-center retrospective cohort study with pathologic review of usual-type adenocarcinoma and adenosquamous carcinoma
Yeorae Kim, Se Ik Kim, Hyojin Kim, Maria Lee, Hee Seung Kim, Kidong Kim, Hyun Hoon Chung, Jae Hong No, Yong Beom Kim, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song, Cheol Lee, Dong Hoon Suh
Gynecologic Oncology.2022; 167(1): 28. CrossRef
Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer
Fuyun Zhang, Xiaomei Song
American Journal of Clinical Oncology.2022; 45(11): 465. CrossRef
Surgical Approach and Use of Uterine Manipulator Are Not Associated with LVSI in Surgery for Early-stage Cervical Cancer
Yinxia Liu, Shuying Huang, Xiu Ming, Huining Jing, Zhengyu Li
Journal of Minimally Invasive Gynecology.2021; 28(9): 1573. CrossRef
Minimally Invasive Radical Hysterectomy for Cervical Cancer: A Systematic Review and Meta-analysis
Anna Jo Bodurtha Smith, Tiffany Nicole Jones, Diana Miao, Amanda Nickles Fader
Journal of Minimally Invasive Gynecology.2021; 28(3): 544. CrossRef
The Surgeon’s Proficiency Affected Survival Outcomes of Minimally Invasive Surgery for Early-Stage Cervical Cancer: A Retrospective Study of 851 Patients
Ying Yang, Yue Huang, Zhengyu Li
Frontiers in Oncology.2021;[Epub] CrossRef
MicroRNA-300 Inhibits the Proliferation and Metastasis of Cervical Cancer Cells via Posttranscriptional Suppression of G Protein-Coupled Receptor 34 (GPR34)
Mei Wang, Ying Tian, Lin Miao, Wenxia Zhao, Antonio Raffone
Journal of Oncology.2021; 2021: 1. CrossRef

7,082 View
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16 Crossref

A Preoperative Nomogram for Predicting Chemoresistance to Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Squamous Carcinoma Treated with Radical Hysterectomy: Zhengjie Ou, Dan Zhao, Bin Li, Yating Wang, Shuanghuan Liu, Yanan Zhang; Cancer Res Treat. 2021;53(1):233-242. Published online September 14, 2020; DOI: https://doi.org/10.4143/crt.2020.159

Abstract PDF PubReader ePub

Purpose
This study aimed to investigate the factors associated with chemoresistance to neoadjuvant chemotherapy (NACT) followed by radical hysterectomy (RH) and construct a nomogram to predict the chemoresistance in patients with locally advanced cervical squamous carcinoma (LACSC).
Materials and Methods
This retrospective study included 516 patients with International Federation of Gynecology and Obstetrics (2003) stage IB2 and IIA2 cervical cancer treated with NACT and RH between 2007 and 2017. Clinicopathologic data were collected, and patients were assigned to training (n=381) and validation (n=135) sets. Univariate and multivariate analyses were performed to analyze factors associated with chemoresistance to NACT. A nomogram was built using the multivariate logistic regression analysis results. We evaluated the discriminative ability and accuracy of the model using a concordance index and a calibration curve. The predictive probability of chemoresistance to NACT was defined as > 34%.
Results
Multivariate analysis confirmed menopausal status, clinical tumor diameter, serum squamous cell carcinoma antigen level, and parametrial invasion on magnetic resonance imaging before treatment as independent prognostic factors associated with chemoresistance to NACT. The concordance indices of the nomogram for training and validation sets were 0.861 (95% confidence interval [CI], 0.822 to 0.900) and 0.807 (95% CI, 0.807 to 0.888), respectively. Calibration plots revealed a good fit between the modelpredicted probabilities and actual probabilities (Hosmer-Lemeshow test, p=0.597). Furthermore, grouping based on the nomogram was associated with progression-free survival.
Conclusion
We developed a nomogram for predicting chemoresistance in LACSC patients treated with RH. This nomogram can help physicians make clinical decisions regarding primary management and postoperative follow-up of the patients.

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Are biomarkers expression and clinical-pathological factors predictive markers of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer?
Antonino Ditto, Mariangela Longo, Giulia Chiarello, Luigi Mariani, Biagio Paolini, Umberto Leone Roberti Maggiore, Fabio Martinelli, Giorgio Bogani, Francesco Raspagliesi
European Journal of Surgical Oncology.2024; 50(6): 108311. CrossRef
A Deep Learning Radiomics Nomogram to Predict Response to Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer: A Two-Center Study
Yajiao Zhang, Chao Wu, Zhibo Xiao, Furong Lv, Yanbing Liu
Diagnostics.2023; 13(6): 1073. CrossRef
Machine Learning-Assisted Ensemble Analysis for the Prediction of Response to Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer
Yibao Huang, Qingqing Zhu, Liru Xue, Xiaoran Zhu, Yingying Chen, Mingfu Wu
Frontiers in Oncology.2022;[Epub] CrossRef

5,610 View
124 Download
4 Web of Science
3 Crossref

Cervical Cancer Screening Rate and Willingness among Female Migrants in Shenzhen, China: Three-Year Changes in Citywide Surveys: Wei Lin, Bin Chen, Bo Wu, Shixin Yuan, Chuyan Zhong, Weikang Huang, Haiyan Hu, Zhihua Liu, Yueyun Wang; Cancer Res Treat. 2021;53(1):212-222. Published online September 1, 2020; DOI: https://doi.org/10.4143/crt.2020.219

Abstract PDF PubReader ePub

Purpose
This study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city.
Materials and Methods
Two citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years.
Results
In total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened.
Conclusion
Identifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.

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Using planned behavior theory to understand cervical cancer screening intentions in Chinese women
Tingting Xin, Yuting Jiang, Chunting Li, Xian Ding, Zhu Zhu, Xiao Chen
Frontiers in Public Health.2023;[Epub] CrossRef
Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China
Wei Lin, Weikang Huang, Chaofan Mei, Peiyi Liu, He Wang, Shixin Yuan, Xiaoshan Zhao, Yueyun Wang
BMC Public Health.2023;[Epub] CrossRef
Risk of cervical intraepithelial neoplasia grade 3 or more diagnoses for human papillomavirus16/18-positive women by cytology and co-infection status
Mengyin Ao, Xiaoxi Yao, Danxi Zheng, Xuesai Gu, Mingrong Xi
Infectious Agents and Cancer.2023;[Epub] CrossRef
Populations at high risk of cervical cancer in Guangxi Province: Findings from two screening projects in a minority area of South China
Huaxiang Lu, Haoyu He, Jian Qin, Mingjian Chen, Qiumei Liu, Min Li, Yongsheng Huang, Anxiang Wei, Shuzhen Liu, Min Xu, Zhiyong Zhang
Journal of Medical Screening.2022; 29(1): 44. CrossRef
Willingness to utilize cervical cancer screening among Ethiopian women aged 30–65 years
Adugna Alemu Desta, Fikadu Tolesa Alemu, Moges Beya Gudeta, Dejene Edosa Dirirsa, Andualem Gezahegn Kebede
Frontiers in Global Women's Health.2022;[Epub] CrossRef
Status quo and problem analysis of cervical cancer screening program in China: Based on RE-AIM framework
Jingfen Zhu, Zhenghao Ge, Jiawei Xia, Qi Liu, Qingqing Ran, Yongbin Yang
Frontiers in Public Health.2022;[Epub] CrossRef

6,590 View
113 Download
6 Web of Science
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Pretreatment Lymph Node Metastasis as a Prognostic Significance in Cervical Cancer: Comparison between Disease Status: Soo Young Jeong, Hyea Park, Myeong Seon Kim, Jun Hyeok Kang, E Sun Paik, Yoo-Young Lee, Tae Joong Kim, Jeong Won Lee, Byoung-Gie Kim, Duk Soo Bae, Chel Hun Choi; Cancer Res Treat. 2020;52(2):516-523. Published online October 29, 2019; DOI: https://doi.org/10.4143/crt.2019.328

Abstract PDF Supplementary Material PubReader ePub

Purpose
Lymph node metastasis (LNM) is the most significant prognostic factor in cervical cancer that was recently incorporated into the International Federation of Gynecology and Obstetrics (FIGO) staging system. This study was performed to evaluate whether the prognostic significance of LNM differs according to disease status.
Materials and Methods
Patients with FIGO stage IB or higher cervical cancer who had pretreatment computed tomography and/or magnetic resonance imaging studies as well as long-term follow-up were enrolled in this retrospective study. The hazard ratio (HR) of Cox regression was used to determine the prognostic significance of LNM. The HRs were compared between the different tumor groups (based on stage, histology, tumor size, primary treatment, age, parametrium involvement, and lymphovascular space invasion).
Results
A total of 970 patients treated between January 1999 and December 2007 were included. The pretreatment LNM had prognostic significance in patients with stage IB1/IIA (HR for progression-free survival 2.10, p=0.001; HR for overall survival 1.99, p=0.005). However, the significance gradually decreased or disappeared with advancing stages. Similarly, the prognostic significance of the pretreatment LNM decreased with advancing disease status, including old age, parametrial involvement or lymphovascular space involvement. In contrast, the tumor size was associated with the prognostic significance of LNM with advancing status. The significance of the clinical LNM did not reflect the significance of the clinical stage. In contrast, the tumor size, parametrial involvement, and significance of the pathologic LNM reflected the clinical stage.
Conclusion
In patients with cervical cancer, pretreatment LNM on imaging has different clinical significance depending on the tumor status.

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Mu Xu, Xiaoyan Xie, Liangzhi Cai, Yongjin Xie, Qiao Gao, Pengming Sun
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Prognostic Model for Survival and Recurrence in Patients with Early-Stage Cervical Cancer: A Korean Gynecologic Oncology Group Study (KGOG 1028): E Sun Paik, Myong Cheol Lim, Moon-Hong Kim, Yun Hwan Kim, Eun Seop Song, Seok Ju Seong, Dong Hoon Suh, Jong-Min Lee, Chulmin Lee, Chel Hun Choi; Cancer Res Treat. 2020;52(1):320-333. Published online August 5, 2019; DOI: https://doi.org/10.4143/crt.2019.124

Abstract PDF PubReader ePub

Purpose
We aimed to develop and validate individual prognostic models in a large cohort of cervical cancer patients that were primarily treated with radical hysterectomy.
Materials and Methods
We analyzed 1,441 patients with early-stage cervical cancer treated between 2000 and 2008 from the Korean Gynecologic Oncology Group multi-institutional cohort: a train cohort (n=788) and a test cohort (n=653). Models predicting the risk for overall survival (OS), disease- free survival (DFS), lymphatic recurrence and hematogenous recurrence were developed using Cox analysis and stepwise backward selection and best-model options. The prognostic performance of each model was assessed in an independent patient cohort. Model-classified risk groups were compared to groups based on traditional risk factors.
Results
Independent risk factors for OS, DFS, lymphatic recurrence, and hematogenous recurrence were identified for prediction model development. Different combinations of risk factors were shown for each outcome with best predictive value. In train cohort, area under the curve (AUC) at 2 and 5 years were 0.842/0.836 for recurrence, and 0.939/0.882 for OS. When applied to a test cohort, the model also showed accurate prediction result (AUC at 2 and 5 years were 0.799/0.723 for recurrence, and 0.844/0.806 for OS, respectively). The Kaplan-Meier plot by proposed model-classified risk groups showed more distinctive survival differences between each risk group.
Conclusion
We developed prognostic models for OS, DFS, lymphatic and hematogenous recurrence in patients with early-stage cervical cancer. Combining weighted clinicopathologic factors, the proposed model can give more individualized predictions in clinical practice.

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Woo Yeon Hwang, Chel Hun Choi, Kidong Kim, Moon-Hong Kim, Myong Cheol Lim, Banghyun Lee, Myounghwan Kim, Yun Hwan Kim, Seok Ju Seong, Jong-Min Lee
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Simin He, Guiming Zhu, Ying Zhou, Boran Yang, Juping Wang, Zhaoxia Wang, Tong Wang
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From the Beginning of the Korean Gynecologic Oncology Group to the Present and Next Steps
Kyung-Jin Min, Nam Kyeong Kim, Jae-Yun Song, Min Chul Choi, Shin Wha Lee, Keun Ho Lee, Min Kyu Kim, Sokbom Kang, Chel Hun Choi, Jeong-Won Lee, Eun-Ju Lee, Keun-Yong Eom, Sang Wun Kim, Hanbyoul Cho, Sun Joo Lee, Myong Cheol Lim, Jaeman Bae, Chong Woo Yoo,
Cancers.2024; 16(19): 3422. CrossRef
Prognostic Factors for Cervical Cancer in Asian Populations: A Scoping Review of Research From 2013 to 2023
Syed S Abrar, Seoparjoo Azmel Mohd Isa, Suhaily Mohd Hairon, Najib M Yaacob, Mohd Pazudin Ismail
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Radiomics based on MRI in predicting lymphovascular space invasion of cervical cancer: a meta-analysis
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Paip1 Indicated Poor Prognosis in Cervical Cancer and Promoted Cervical Carcinogenesis: Nan Li, Junjie Piao, Xinyue Wang, Ki-Yeol Kim, Jung Yoon Bae, Xiangshan Ren, Zhenhua Lin; Cancer Res Treat. 2019;51(4):1653-1665. Published online April 19, 2019; DOI: https://doi.org/10.4143/crt.2018.544

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was aimed to investigate the role of poly(A)-binding protein-interacting protein 1 (Paip1) in cervical carcinogenesis.
Materials and Methods
The expression of Paip1 in normal cervical epithelial tissues and cervical cancer (CC) tissues were detected by immunohistochemistry. In vivo and in vitro assays were performed to validate effect of Paip1 on CC progression.
Results
Paip1 was found to be up-regulated in CC, which was linked with shorter survival. Knockdown of Paip1 inhibited cell growth, induced apoptosis and cell cycle arrest in CC cells, whereas its overexpression reversed these effects. The in vivo tumor model confirmed the pro-tumor role of Paip1 in CC growth.
Conclusion
Altogether, the investigation demonstrated the clinical significance of Paip1 expression, which prompted that the up-regulated of Paip1 can presumably be a potential prognostic and progression marker for CC.

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T. Mallikarjuna, N. B. Thummadi, Vaibhav Vindal, P. Manimaran
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Jianfeng Zheng, Weiwei Fan, Xiaoyu Zhang, Weili Quan, Yunfei Wu, Mengni Shu, Moyang Chen, Ming Liang
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Prioritizing the candidate genes related to cervical cancer using the moment of inertia tensor
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Comparative Effectiveness of Abdominal versus Laparoscopic Radical Hysterectomy for Cervical Cancer in the Postdissemination Era: Jin Hee Kim, Kyungjoo Kim, Seo Jin Park, Jung-Yun Lee, Kidong Kim, Myong Cheol Lim, Jae Weon Kim; Cancer Res Treat. 2019;51(2):788-796. Published online September 11, 2018; DOI: https://doi.org/10.4143/crt.2018.120

Abstract PDF Supplementary Material PubReader ePub

Purpose
Despite the benefits of minimally invasive surgery for cervical cancer, there are a lack of randomized trials comparing laparoscopic radical hysterectomy and abdominal radical hysterectomy. We compared morbidity, cost of care, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer.
Materials and Methods
We used the Korean nationwide database to identify women with cervical cancer who underwent radical hysterectomy from January 1, 2011 to December 31, 2014. Patients who underwent abdominal radical hysterectomy were compared to those who underwent laparoscopic radical hysterectomy. Perioperative morbidity, the use of adjuvant therapy, and survival were evaluated after propensity score balancing.
Results
We identified 6,335 patients, including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. The use of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger, had a more recent year of diagnosis, and were treated in the metropolitan area were more likely to undergo a laparoscopic procedure (p < 0.001). Compared to abdominal radical hysterectomy, laparoscopic radical hysterectomy was associated with lower rates of complication, fewertransfusions, a shorter hospital stay, less adjuvant therapy, and reduced total medical costs (p < 0.001). Laparoscopic surgery was associated with a better overall survival than abdominal operation (hazard ratio, 0.74; 95% confidence interval, 0.64 to 0.85).
Conclusion
In the postdissemination era, laparoscopic radical hysterectomy was associated with more favorable morbidity profiles, a lower cost of care, and comparable survival than abdominal radical hysterectomy.

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The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04): Jeanny Kwon, Keun-Young Eom, Young Seok Kim, Won Park, Mison Chun, Jihae Lee, Yong Bae Kim, Won Sup Yoon, Jin Hee Kim, Jin Hwa Choi, Sei Kyung Chang, Bae Kwon Jeong, Seok Ho Lee, Jihye Cha; Cancer Res Treat. 2018;50(3):964-974. Published online October 24, 2017; DOI: https://doi.org/10.4143/crt.2017.346

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence.
Materials and Methods
A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pNstage, number of mPLN, lymph node (LN)ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)).
Results
In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ ‒0.58 vs. > ‒0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71).
Conclusion
mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

Citations

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Survival Nomograms after Curative Neoadjuvant Chemotherapy and Radical Surgery for Stage IB2-IIIB Cervical Cancer: Claudia Marchetti, Francesca De Felice, Anna Di Pinto, Alessia Romito, Angela Musella, Innocenza Palaia, Marco Monti, Vincenzo Tombolin, Ludovico Muzii, PierLuigi Benedetti Panici; Cancer Res Treat. 2018;50(3):768-776. Published online July 19, 2017; DOI: https://doi.org/10.4143/crt.2017.141

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to develop nomograms for predicting the probability of overall survival (OS) and progression-free survival (PFS) in locally advanced cervical cancer treated with neoadjuvant chemotherapy and radical surgery.
Materials and Methods
Nomograms to predict the 5-year OS rates and the 2-year PFS rates were constructed. Calibration plots were constructed, and concordance indices were calculated. Evaluated variableswere body mass index, age, tumor size, tumor histology, grading, lymphovascular space invasion, positive parametria, and positive lymph nodes.
Results
In total 245 patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy and radical surgery were included for the construction of the nomogram. The 5-year OS and PFS were 72.6% and 66%, respectively. Tumor size, grading, and parametria status affected the rate of OS, whereas tumor size and positive parametria were the main independent PFS prognostic factors.
Conclusion
We constructed a nomogram based on clinicopathological features in order to predict 2-year PFS and 5-year OS in locally advanced cervical cancer primarily treated with neoadjuvant chemotherapy followed by radical surgery. This tool might be particularly helpful for assisting in the follow-up of cervical cancer patients who have not undergone concurrent chemoradiotherapy.

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Proton Pump Inhibition Enhances the Cytotoxicity of Paclitaxel in Cervical Cancer: Taejong Song, Hye-Kyung Jeon, Ji Eun Hong, Jung-Joo Choi, Tae-Joong Kim, Chel Hun Choi, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee; Cancer Res Treat. 2017;49(3):595-606. Published online September 27, 2016; DOI: https://doi.org/10.4143/crt.2016.034

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to investigate whether a proton pump inhibitor (PPI) could enhance chemosensitivity via the inhibition of vacuolar-type H+ ATPase (V-ATPase) in cervical cancer.
Materials and Methods
The expression of V-ATPase was evaluated in 351 formalin-fixed, paraffin-embedded human cervical cancer tissues using immunohistochemistry and compared with clinicopathologic risk factors for disease prognosis. The influence of cell proliferation and apoptosis following V-ATPase siRNA transfection or esomeprazole pretreatment was assessed in cervical cancer cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and enzyme-linked immunosorbent assay, respectively.
Results
Immunohistochemical analysis revealed that V-ATPase was expressed in about 60% of cervical cancer tissue samples (211/351), and the expression was predominantly found in adenocarcinoma histology (p=0.016). Among patients with initially bulky cervical cancer (n=89), those with V-ATPase expression had shorter disease-free survival (p=0.005) and overall survival (p=0.023). Co-treatment with V-ATPase siRNA or esomeprazole with paclitaxel significantly decreased the cell proliferation of cervical cancer cell lines, including HeLa and INT407, compared to cell lines treated with paclitaxel alone (p < 0.01). Moreover, V-ATPase siRNA or esomeprazole followed by paclitaxel significantly increased the expression of active caspase-3 in these cells compared to cells treated with paclitaxel alone (both, p < 0.05).
Conclusion
V-ATPase was predominantly expressed in cervical adenocarcinoma, and the expression of V-ATPases was associated with poor prognosis. The inhibition of V-ATPase via siRNA or PPI (esomeprazole) might enhance the chemosensitivity of paclitaxel in cervical cancer cells.

Citations

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Proton Pump Inhibitor Use and Obesity-Associated Cancer in the Women’s Health Initiative
Tarah J. Ballinger, Zora Djuric, Sagar Sardesai, Kathleen M. Hovey, Chris A. Andrews, Theodore M. Brasky, Jian Ting Zhang, Thomas E Rohan, Nazmus Saquib, Aladdin H. Shadyab, Michael Simon, Jean Wactawski-Wende, Robert Wallace, Ikuko Kato
Nutrition and Cancer.2023; 75(1): 265. CrossRef
Esomeprazole Alleviates Cisplatin Resistance by Inhibiting the AKT/mTOR Pathway in Ovarian Cancer Cells
Jingya Duan, Zisen Zhang, Jinfeng Du, Jihua Zhang, Minmin Li, Canyu Li
OncoTargets and Therapy.2023; Volume 16: 425. CrossRef
Proton pump inhibitors may enhance the risk of digestive diseases by regulating intestinal microbiota
Liang Tian, Chongfei Huang, Wenkang Fu, Long Gao, Ningning Mi, Mingzhen Bai, Haidong Ma, Chao Zhang, Yawen Lu, Jinyu Zhao, Xianzhuo Zhang, Ningzu Jiang, Yanyan Lin, Ping Yue, Jinqiu Yuan, Wenbo Meng
Frontiers in Pharmacology.2023;[Epub] CrossRef
Depression Events Associated with Proton-Pump Inhibitors in Postmarketing Drug Surveillance Data
Tigran Makunts, Haroutyun Joulfayan, Kenneth Ta, Ruben Abagyan
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Association between Proton Pump Inhibitor Use and the Risk of Female Cancers: A Nested Case-Control Study of 23 Million Individuals
Nhi Thi Hong Nguyen, Chih-Wei Huang, Ching-Huan Wang, Ming-Chin Lin, Jason C. Hsu, Min-Huei Hsu, Usman Iqbal, Phung-Anh Nguyen, Hsuan-Chia Yang
Cancers.2022; 14(24): 6083. CrossRef
Emerging insights on the role of V‐ATPase in human diseases: Therapeutic challenges and opportunities
Cátia Santos‐Pereira, Lígia R. Rodrigues, Manuela Côrte‐Real
Medicinal Research Reviews.2021; 41(4): 1927. CrossRef
Omeprazole improves chemosensitivity of gastric cancer cells by m6A demethylase FTO-mediated activation of mTORC1 and DDIT3 up-regulation
Shuitu Feng, Guoqin Qiu, Lihong Yang, Lihua Feng, Xin Fan, Fang Ren, Kaida Huang, Yide Chen
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Precise Cancer Anti-acid Therapy Monitoring Using pH-Sensitive MnO2@BSA Nanoparticles by Magnetic Resonance Imaging
Rong A, Yuzhu Yao, Xiaolu Guo, Weiqi Jiang, Meng Jiang, Jie Yang, Yingbo Li, Olagbaju Oluwatosin Atinuke, Xuesong Hu, Yuanyuan Li, Xiance Wang, Lili Yang, Xiangliang Yang, Kai Wang, Jun Hu, Xilin Sun
ACS Applied Materials & Interfaces.2021; 13(16): 18604. CrossRef
Rabeprazole has efficacy per se and reduces resistance to temozolomide in glioma via EMT inhibition
Deepak Babu, Anwita Mudiraj, Neera Yadav, Chandrashekhar Y.B.V.K., Manas Panigrahi, Phanithi Prakash Babu
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Shekoufeh Almasi, Yassine El Hiani
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Serum- and glucocorticoid- inducible kinase 2, SGK2, is a novel autophagy regulator and modulates platinum drugs response in cancer cells
Valentina Ranzuglia, Ilaria Lorenzon, Ilenia Pellarin, Maura Sonego, Alessandra Dall’Acqua, Sara D’Andrea, Sara Lovisa, Ilenia Segatto, Michela Coan, Jerry Polesel, Diego Serraino, Patrizia Sabatelli, Paola Spessotto, Barbara Belletti, Gustavo Baldassarre
Oncogene.2020; 39(40): 6370. CrossRef
Elevated expression of the V‐ATPase D2 subunit triggers increased energy metabolite levels in KrasG12D‐driven cancer cells
Jigang Yang, Feihu Guo, Leilei Yuan, Guangxin Lv, Jianhua Gong, Jing Chen
Journal of Cellular Biochemistry.2019; 120(7): 11690. CrossRef
Pantoprazole attenuates tumorigenesis via inhibition of exosomal secretion in a rat model of hepatic precancerous lesion induced by diethylnitrosamine and 2‐acetamidofluorene
Marwa Matboli, Asmaa Abd ElGwad, Amany H. Hasanin, Ahmed El‐Tawdi, Eman K. Habib, Rasha Ahmed` Elmansy, Doaa Ibrahim, Hanan Shehata, Fathy Tash
Journal of Cellular Biochemistry.2019; 120(9): 14946. CrossRef
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Bradleigh Whitton, Haruko Okamoto, Graham Packham, Simon J. Crabb
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Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea: Eun-Kyeong Moon, Chang-Mo Oh, Young-Joo Won, Jong-Keun Lee, Kyu-Won Jung, Hyunsoon Cho, Jae Kwan Jun, Myong Cheol Lim, Moran Ki; Cancer Res Treat. 2017;49(2):526-533. Published online September 1, 2016; DOI: https://doi.org/10.4143/crt.2016.316

Abstract PDF PubReader ePub

Purpose
This study was conducted to describe the trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea.
Materials and Methods
The incidence and mortality rate of cervical cancer among ≥ 20-year-old women from 1993 to 2012 were obtained from the Korea Central Cancer Registry and the Korean Statistical Information Service. Age-standardized rates were calculated and Joinpoint regression was used to evaluate the trends in the incidence and mortality rate. Age-period-cohort analysis was performed to investigate the independent effects of age, period and cohort.
Results
The incidence of cervical cancer decreased from 32.8 per 100,000 in 1993 to 15.9 per 100,000 in 2012 (annual percent change [APC], –3.9%; 95% confidence interval [CI], –4.2% to –3.6%). The mortality rate decreased from 5.2 per 100,000 in 1993 to 2.1 per 100,000 in 2012 (APC, –4.8%; 95% CI, –5.1% to –4.4%); however, the incidence and mortality rates among young women (< 30 years old) increased. An age-period-cohort model of the incidence and mortality rate showed decreasing period effects between 1993 and 2008 and decreasing cohort effects between 1928 and 1973, while birth cohorts after 1973 exhibited slight increases in the incidence and mortality rate of cervical cancer.
Conclusion
Recent decreases in the incidence and mortality rate of cervical cancer were due to decreases in the period and cohort effects, which reflect the implementation of a cancer screening program and changes in lifestyle. However, our findings also highlighted an increase in cohort effects on the incidence and mortality rate among young women born after 1973.

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Comparison of Quality of Life and Sexuality between Cervical Cancer Survivors and Healthy Women: Yumi Lee, Myong Cheol Lim, Se Ik Kim, Jungnam Joo, Dong Ock Lee, Sang-Yoon Park; Cancer Res Treat. 2016;48(4):1321-1329. Published online February 12, 2016; DOI: https://doi.org/10.4143/crt.2015.425

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to compare quality of life (QoL) and sexual functioning between sexually active cervical cancer survivors and healthy women.
Materials and Methods
In this cross-sectional study, propensity-score-matched cervical cancer survivors (n=104) and healthy women (n=104) were compared. All women had engaged in sexual activity within the previous 3 months, and cervical cancer survivors showed no evidence of disease after primary treatment. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Cervical Cancer Module (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).
Results
Significantly higher scores for lymphedema were observed in the cervical cancer survivors group compared with the healthy women group (mean, 20.2 vs. 12.2; p < 0.05). Sexuality, both in terms of sexual activity, sexual enjoyment, and sexual worry (EORTC QLQ-CX24), and in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain (FSFI) were similar between the groups. When the scale of sexual/vaginal functioning in EORTC QLQ-CX24 was divided into individual questions, cervical cancer survivors reported shorter vaginal length than the control group, but without statistical significance (mean, 80.6 vs. 85.4; p=0.077).
Conclusion
Compared with healthy women, sexuality was not impaired in cervical cancer survivors who showed no evidence of disease after primary treatment and engaging in sexual activity. Further prospective cohort studies are warranted to confirm this finding.

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A Clinicopathological Review of Pulmonary Metastasis from Uterine Cervical Cancer: Eun Young Ki, Keun Ho Lee, Jong Sup Park, Soo Young Hur; Cancer Res Treat. 2016;48(1):266-272. Published online February 23, 2015; DOI: https://doi.org/10.4143/crt.2014.206

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the clinicopathological features of pulmonary metastasis from cervical cancer. Materials and Methods We reviewed the medical records of 56 patients with cervical cancer who developed pulmonary metastasis after radical hysterectomy, postoperative concurrent chemoradiation or systemic chemotherapy between January 1990 and March 2014.
Results
Fifty-six patients were diagnosed with pulmonary metastasis from cervical cancer. The prevalence of pulmonary metastasis was 3.6%. The mean event-free duration was 12 months. Twelve patients underwent surgical removal of metastatic lesions. The overall survival (OS) of patients with ≤ 3 metastatic lung lesions was 40.7 months, longer than those with > 4 lesions (25 months, p=0.034). The OS of patients who underwent surgical resection was 53.8 months, longer than that of those who did not (p=0.006). In addition, the OS of patients with adjuvant platinum-based chemotherapy was 32.6 months (p=0.027). Conclusion In this study, we found that the number of metastatic nodules, surgical resection, and postoperative platinum-based chemotherapy can influence clinical outcome. Further studies on prognostic factors and successful treatment modalities are warranted.

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Blockade of Autophagy Aggravates Endoplasmic Reticulum Stress and Improves Paclitaxel Cytotoxicity in Human Cervical Cancer Cells: Li Xu, Jing-Hua Liu, Jing Zhang, Na Zhang, Zan-Hong Wang; Cancer Res Treat. 2015;47(2):313-321. Published online September 11, 2014; DOI: https://doi.org/10.4143/crt.2013.222

Abstract PDF PubReader ePub

Purpose
Autophagy is one of the ways to degrade unfolded proteins after endoplasmic reticulum (ER) stress. The purpose of this study is to determine whether a blockade of autophagy leads to aggravated endoplasmic reticulum stress, which then induces cells apoptosis in HeLa cells treated with paclitaxel.
Materials and Methods
Autophagy activation and the proapoptotic effects were characterized using monodansylcadaverine labeling and Hoechest staining, respectively. A Western blot analysis was used to detect the expression of apoptotic and autophagy-related genes. A flow cytometry was used to assess the cell apoptosis ratio.
Results
Paclitaxel exposure induced the aggregation of autophagosomes in the cytoplasms of cervical cancer HeLa cells. The expression of Beclin 1 and LC3 II were upregulated, but p62 was downregulated, which suggests that autophagy was promoted by paclitaxel. On the other hand, the expression of GRP78 obviously increased, suggesting that ER stress was induced after paclitaxel treatment. The cell proliferation assay indicated that a knockdown of Beclin 1 sensitized HeLa cells to paclitaxel. Furthermore, paclitaxel-mediated apoptotic cell death was further potentiated by the pretreatment with autophagy inhibitor chloroquine or small interfering RNA against Beclin 1. These results suggest that an induction of autophagy by paclitaxel may induce cell survival rather than cell death in HeLa cells; moreover, inhibition of autophagy led to an aggravated ER stress and an induction of downstream apoptosis.
Conclusion
Our results reveal autophagy induced by paclitaxel conferred protection of tumor cells against apoptosis, and blockade of autophagy subsequently aggravated ER stress, enhancing the apoptosis associated with paclitaxel treatment in HeLa cells.

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Impact of Chemoradiation on Prognosis in Stage IVB Cervical Cancer with Distant Lymphatic Metastasis: Hee Seung Kim, Taehun Kim, Eung Seok Lee, Hak Jae Kim, Hyun Hoon Chung, Jae Weon Kim, Yong Sang Song, Noh Hyun Park; Cancer Res Treat. 2013;45(3):193-201. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.193

Abstract PDF PubReader ePub

PURPOSE
The purpose of this study was to determine whether chemoradiation (CCR) is efficient for improving prognosis, compared with systemic chemotherapy (SC), in patients with stage IVB cervical cancer who have distant lymphatic metastasis.
MATERIALS AND METHODS
Among 2,322 patients with cervical cancer between January 2000 and March 2010, 43 patients (1.9%) had stage IVB disease. After exclusion of 19 patients due to insufficient data and hematogenous metastasis, 24 patients (1%) who received CCR (n=10) or SC (n=14) were enrolled. We compared tumor response, progression-free survival (PFS) and overall survival (OS), and disease recurrence between CCR and SC.
RESULTS
Complete response rates were 60% and 0% after CCR and SC (p<0.01). Grade 3 or 4 leukopenia was more common in patients treated with CCR (24.4% vs. 9.1%, p=0.03), whereas grade 3 or 4 neuropenia was more frequent in those treated with SC (28.4% vs. 11.1%, p=0.03). Development of grade 3 proctitis occurred as a late radiotherapy (RT)-related toxicity in only one patient (10%) treated with CCR. In addition, squamous cell carcinoma and CCR were favorable prognostic factors for improvement of PFS (adjusted hazard ratios [HRs], 0.17 and 0.12; 95% confidence intervals [CIs], 0.04 to 0.80 and 0.03 to 0.61), and only CCR was significant for improvement of OS (adjusted HR, 0.15; 95% CI, 0.02 to 0.90). However, no differences in the rate and pattern of disease recurrence were observed between CCR and SC.
CONCLUSION
CCR may be more effective than SC for improving survival, and can be regarded as a feasible method with some caution regarding late RT-related toxicity for treatment of stage IVB cervical cancer with distant lymphatic metastasis.

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International Journal of Gynecologic Cancer.2019; 29(3): 487. CrossRef
Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System
Shilong Zhang, Xin Wang, Zhanming Li, Wenrong Wang, Lishun Wang
Frontiers in Oncology.2019;[Epub] CrossRef
Special Focus on Stage IV Cervical Cancer Patients: A Decade Experience
Sophie Espenel, Max Adrien Garcia, Julien Langrand-Escure, Alexis Vallard, Jane Chloé Trone, Chloé Rancoule, Nicolas Vial, Pablo Moreno-Acosta, Céline Chauleur, Claire Boutet, Michel Peoc'h, Nathalie Prevot-Bitot, Jean Baptiste Guy, Nicolas Magné
Oncology.2019; 97(3): 125. CrossRef
Selection and identification of novel peptides specifically targeting human cervical cancer
Xiaomin Liu, Jingwen Peng, Jie He, Qiaoran Li, Jianbin Zhou, Xiaoqiu Liang, Shengsong Tang
Amino Acids.2018; 50(5): 577. CrossRef
Radiotherapy Improves the Survival of Patients With Metastatic Cervical Cancer: A Propensity-Matched Analysis of SEER Database
Kejie Huang, Mingfang Jia, Ping Li, Jianglong Han, Rui Zhang, Qin Li, Yunfeng Qiao, TangPeng Xu, Peng Ruan, Qibin Song, Yanbo Li, Zhenming Fu
International Journal of Gynecologic Cancer.2018; 28(7): 1360. CrossRef
Race and nodal disease status are prognostic factors in patients with stage IVB cervical cancer
Shin Nishio, Koji Matsuo, Koji Yonemoto, Mototsugu Shimokawa, Masayuki Hosaka, Michiko Kodama, Takahito M. Miyake, Kimio Ushijima, Toshiharu Kamura, Shannon N. Westin, Pamela T. Soliman, Robert L. Coleman
Oncotarget.2018; 9(64): 32321. CrossRef
Predictors of Survival in Patients With FIGO Stage IVB Cervical Cancer
Tomoyuki Sasano, Seiji Mabuchi, Hiromasa Kuroda, Ryoko Takahashi, Katsumi Kozasa, Fumiaki Isohashi, Yasuo Yoshioka, Kazuhiko Ogawa, Tadashi Kimura
International Journal of Gynecological Cancer.2016; 26(3): 528. CrossRef
Advances in diagnosis and treatment of metastatic cervical cancer
Haoran Li, Xiaohua Wu, Xi Cheng
Journal of Gynecologic Oncology.2016;[Epub] CrossRef
Tailored radiotherapeutic strategies for disseminated uterine cervical cancer patients
Jung Ho Im, Hong In Yoon, Sunghoon Kim, Eun Ji Nam, Sang Wun Kim, Ga Won Yim, Ki Chang Keum, Young Tae Kim, Gwi Eon Kim, Yong Bae Kim
Radiation Oncology.2015;[Epub] CrossRef
Cancer of the cervix uteri
Adriana Bermudez, Neerja Bhatla, Eric Leung
International Journal of Gynecology & Obstetrics.2015;[Epub] CrossRef
HER2 as a novel therapeutic target for cervical cancer
Doo-Yi Oh, Seokhwi Kim, Yoon-La Choi, Young Jae Cho, Ensel Oh, Jung-Joo Choi, Kyungsoo Jung, Ji-Young Song, Suzie E. Ahn, Byoung-Gie Kim, Duk-Soo Bae, Woong-Yang Park, Jeong-Won Lee, Sangyong Song
Oncotarget.2015; 6(34): 36219. CrossRef
Biological significance and therapeutic implication of resveratrol-inhibited Wnt, Notch and STAT3 signaling in cervical cancer cells
Peng Zhang, Hong Li, Bin Yang, Fan Yang, Lin-Lin Zhang, Qing-You Kong, Xiao-Yan Chen, Mo-Li Wu, Jia Liu
Genes & Cancer.2014; 5(5-6): 154. CrossRef

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Prognostic Value of Different Patterns of Squamous Cell Carcinoma Antigen Level for the Recurrent Cervical Cancer: Bae Kwon Jeong, Seung Jae Huh, Doo Ho Choi, Won Park, Duk Soo Bae, Byoung-Gie Kim; Cancer Res Treat. 2013;45(1):48-54. Published online March 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.1.48

Abstract PDF PubReader ePub

PURPOSE
In some unusual cases, in patients with cervical cancer, an elevation of squamous cell carcinoma antigen (SCC-Ag) was not observed at diagnosis but was observed on recurrence, or vice versa. The objective of this study was to identify patient-, disease-, and treatment-related factors associated with this unusual level of SCC-Ag, and to determine whether SCC-Ag is a useful tumor marker in such patients.
MATERIALS AND METHODS
Among 129 patients with recurrence, 14 who showed a normal SCC-Ag level at diagnosis but an elevated level at recurrence were classified as group I; 22 patients with an elevated SCC-Ag level at diagnosis but not at recurrence were classified as group II; and 76 patients with an elevated SCC-Ag level at both diagnosis and recurrence were classified as group III.
RESULTS
In univariate analysis, unusual SCC-Ag showed statistically significant relationships with pathology and biochemical response to treatment. However, in the multivariate analysis, none of the clinicopathologic factors showed a statistical relationship with unusual levels of SCC-Ag. The 5-year disease-free survival rates for groups I, II, and III were 7.1%, 9.1%, and 0% (p=0.418), and the 5-year overall survival rates were 34.3%, 58.4%, and 33.3% (p=0.142), respectively.
CONCLUSION
The value of SCC-Ag has been confirmed in all patients; thus, check of SCC-Ag level at follow-up should be considered. Although no statistically significant differences were observed among the groups, we conclude that patients with a high initial SCC-Ag and elevated SCC-Ag at relapse have poor prognosis due to high SCC-Ag level.

Citations

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Utility of vaginal vault cytology in the local recurrence of cervical cancer
Kazuto Nakamura, Soichi Yamashita, Keiko Kigure, Toshio Nishimura, Ikuro Ito, Anri Azuma, Kohshiro Nakao, Ken Ando, Tatsuya Kanuma
BMC Women's Health.2023;[Epub] CrossRef
Study on the preoperative value of serum SCC-Ag in predicting the stromal invasion of cervical squamous cell carcinoma
Lin Qin
Journal of Cancer Research and Clinical Oncology.2023; 149(11): 9167. CrossRef
Prognostic Effect of Primary Recurrence Patterns in Squamous Cervical Carcinoma After Radical Surgery
Zongkai Zhang, Long Jiang, Rui Bi, Xiaohua Wu, Guihao Ke, Jun Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
Can serial evaluation of serum SCC-Ag-level predict tumor recurrence and patient survival in squamous-cell carcinoma of uterine cervix treated with definitive chemoradiotherapy? A multi-institutional analysis
Kyu Hye Choi, Mina Yu, Songmi Jeong, Jong Hoon Lee
International Journal of Clinical Oncology.2020; 25(7): 1405. CrossRef
Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors
Hong-tao Guo, Xue-han Bi, Ting Lei, Xiao Lv, Guang Yao, Yao Chen, Chang Liu
BMC Cancer.2020;[Epub] CrossRef
Significance of elevated SCC-Ag level on tumor recurrence and patient survival in patients with squamous-cell carcinoma of uterine cervix following definitive chemoradiotherapy: a multi-institutional analysis
Kyu Hye Choi, Sea-Won Lee, Mina Yu, Songmi Jeong, Jeong Won Lee, Jong Hoon Lee
Journal of Gynecologic Oncology.2019;[Epub] CrossRef
Prognostic Role of Squamous Cell Carcinoma Antigen in Cervical Cancer: A Meta-analysis
Zhenhua Liu, Hongtai Shi
Disease Markers.2019; 2019: 1. CrossRef
The association between serum squamous cell carcinoma antigen and recurrence and survival of patients with cervical squamous cell carcinoma: A systematic review and meta-analysis
Chuenkamon Charakorn, Kunlawat Thadanipon, Sawarat Chaijindaratana, Sasivimol Rattanasiri, Pawin Numthavaj, Ammarin Thakkinstian
Gynecologic Oncology.2018; 150(1): 190. CrossRef
Squamous cell carcinoma antigen expression in tumor cells is associated with the chemosensitivity and survival of patients with cervical cancer receiving docetaxel-carboplatin-based neoadjuvant chemotherapy
Peng Chen, Liang Jiao, Dan-Bo Wang
Oncology Letters.2017; 13(3): 1235. CrossRef
C14ORF166 overexpression is associated with pelvic lymph node metastasis and poor prognosis in uterine cervical cancer
Weijing Zhang, Jianping Ou, Fangyong Lei, Teng Hou, Shu Wu, Chunhao Niu, Liqun Xu, Yanna Zhang
Tumor Biology.2016; 37(1): 369. CrossRef
The assessment of the prognostic value of tumor markers and cytokines as SCCAg, CYFRA 21.1, IL-6, VEGF and sTNF receptors in patients with squamous cell cervical cancer, particularly with early stage of the disease
Beata Kotowicz, Malgorzata Fuksiewicz, Joanna Jonska-Gmyrek, Mariusz Bidzinski, Maria Kowalska
Tumor Biology.2016; 37(1): 1271. CrossRef
The Value of Diffusion-Weighted Imaging in Predicting the Prognosis of Stage IB-IIA Cervical Squamous Cell Carcinoma After Radical Hysterectomy
Guoxing Zhou, Xiao Chen, Fei Tang, Jie Zhou, Yibin Wang, Zhongqiu Wang
International Journal of Gynecological Cancer.2016; 26(2): 361. CrossRef
Relationship of 18F-Fdg Pet/Ct Metabolic, Clinical and Pathological Characteristics of Primary Squamous Cell Carcinoma of the Cervix
Weina Xu, Shupeng Yu, Jun Xin, Qiyong Guo
Journal of Investigative Medicine.2016; 64(8): 1246. CrossRef
Ultrasensitive nonenzymatic immunosensor based on bimetallic gold–silver nanoclusters synthesized by simple mortar grinding route
Xiaoyue Zhang, Feng Li, Qin Wei, Bin Du, Dan Wu, He Li
Sensors and Actuators B: Chemical.2014; 194: 64. CrossRef
Detection of cervical cancer recurrence during follow-up: A multivariable comparison of 9 frequently investigated serum biomarkers
Jacob P. Hoogendam, Afra Zaal, Emma G.G.M. Rutten, Cobi J. Heijnen, Gemma G. Kenter, Wouter B. Veldhuis, René H.M. Verheijen, Ronald P. Zweemer
Gynecologic Oncology.2013; 131(3): 655. CrossRef

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Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer: Hee Seung Kim, Mi-Kyung Kim, Hak Jae Kim, Seung-Su Han, Jae Weon Kim; Cancer Res Treat. 2012;44(2):97-103. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.97

Abstract PDF PubReader ePub

PURPOSE
This study investigated the efficacy and toxicity associated with consolidation chemotherapy using paclitaxel and carboplatin after concurrent chemoradiation (CCR) in cervical cancer patients.
MATERIALS AND METHODS
From a total of 37 patients, 19 with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer (group 1) underwent surgery followed by consolidation chemotherapy after CCR, and 18 with stage IIB-IVA disease (group 2) received consolidation chemotherapy after primary CCR. Three cycles of chemotherapy using paclitaxel (135 mg/m2) and carboplatin (AUC 5.0) were administered every 3 weeks for CCR therapy, and three cycles of consolidation chemotherapy using paclitaxel (175 mg/m2) and carboplatin (AUC 5.0) were used every 3 weeks after CCR.
RESULTS
The complete and partial response rates were 77.8% and 22.2% in group 2. Moreover, the 3-year progression-free and overall survival rates were 62.7% and 90.9% in group 1, and 51.9% and 60% in group 2, respectively. The most common grade 3 or 4 hematologic toxicities observed were leukopenia (group 1, 10.5%; group 2, 13.0%) and neutropenia (group 1, 7.0%; group 2, 14.8%), and grade 3 or 4 diarrhea (group 1, 1.8%) and febrile illness (group 2, 1.9%) were the most frequently observed non-hematologic toxicities. When we compared these results with previous reports, consolidation chemotherapy after CCR using paclitaxel and carboplatin revealed a relatively lower complete response rate (77.8% vs. 87-100%, respectively) and shorter progression-free survival (51.9-62.7% vs. 81-86%, respectively) and overall survival (60-90.9% vs. 81-95%, respectively) in spite of similar toxicity findings.
CONCLUSION
Due to low efficacy results, consolidation chemotherapy using paclitaxel and carboplatin after CCR is not a feasible treatment regimen for high-risk early-stage or locally advanced cervical cancer.

Citations

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Efficacy and safety of consolidation chemotherapy after adjuvant therapy in stage IB-IIA cervical cancer patients with risk factors: a retrospective single-center study
Jiaxin Wang, Huaijuan Guo, Jingjing Yang, Jingxian Mao, Ying Wang, Ruidong Gao, Xuebing Yan, Jie Wang
Frontiers in Oncology.2024;[Epub] CrossRef
The effectiveness of consolidation chemotherapy in high-risk early-stage cervical cancer patients following concurrent chemoradiation after radical surgery
Cong Wang, Chunli Fu, Changdong Ma, Qiuhong Qian, Fangfang He, Guangyu Zhang
Japanese Journal of Clinical Oncology.2023; 53(2): 122. CrossRef
Efficacy and safety of adjuvant chemotherapy for locally advanced cervical cancer: A systematic review and meta-analysis
Xiao Ma, Jin Fang, Lu Zhang, Yao Huang, Hui Shen, Xiaohua Ma, Shuixing Zhang, Bin Zhang
Critical Reviews in Oncology/Hematology.2023; 184: 103953. CrossRef
The effect of consolidation chemotherapy after concurrent chemoradiation on the prognosis of locally advanced cervical cancer: a systematic review and meta-analysis
Lan Zhong, Kemin Li, Liang Song, Rutie Yin
Journal of Obstetrics and Gynaecology.2022; 42(5): 830. CrossRef
Role of Adjuvant Chemotherapy After Concurrent Chemoradiotherapy in Patients With Locally Advanced Cervical Cancer
Lingna Kou, Tao Zhang, Xiling Yang, Siyun Peng, Yifei Wang, Mingyang Yuan, Minmin Li
Future Oncology.2022; 18(16): 1917. CrossRef
Integration of Consolidation Chemotherapy After Concurrent Chemoradiation in the Treatment of Locally Advanced Uterine Cervical Cancer
V. S. Haritha, Laxmi Singotia, Rajesh Jain, A. K. Saxena, Shyamji Rawat, Lalit Patel
Indian Journal of Gynecologic Oncology.2022;[Epub] CrossRef
A Multi-Institutional Retrospective Analysis of Oncologic Outcomes for Patients With Locally Advanced Cervical Cancer Undergoing Platinum-Based Adjuvant Chemotherapy After Concurrent Chemoradiotherapy
Ning Wu, Xing Su, Honglin Song, Ying Li, Fei Gu, Xiaoge Sun, Xiaofan Li, Guanghui Cheng
Cancer Control.2021;[Epub] CrossRef
Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis
Nanda Horeweg, Prachi Mittal, Patrycja L. Gradowska, Ingrid Boere, Supriya Chopra, Remi A. Nout
Cancers.2021; 13(8): 1880. CrossRef
How should we stage and tailor treatment strategy in locally advanced cervical cancer? Imaging versus para-aortic surgical staging
Alejandra Martinez, Martina Aida Angeles, Denis Querleu, Gwenael Ferron, Christophe Pomel
International Journal of Gynecologic Cancer.2020; 30(9): 1434. CrossRef
Clinical Analysis of Apatinib in the Treatment of Patients with Residual Tumor after Radical Chemoradiotherapy for Locally Advanced Cervical Cancer
Jun Jiang, Wei Hong Wei, Tao Xu
Journal of Cancer Research Updates.2020; 9(1): 20. CrossRef
Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients
Seiji Mabuchi, Fumiaki Isohashi, Mika Okazawa, Fuminori Kitada, Shintaro Maruoka, Kazuhiko Ogawa, Tadashi Kimura
Journal of Gynecologic Oncology.2017;[Epub] CrossRef
Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer
Kyungmi Yang, Won Park, Seung Jae Huh, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee
Radiation Oncology Journal.2017; 35(1): 39. CrossRef
Substantieller Vorteil durch CT-geplante HDR-Brachytherapie bei Zervixkarzinompatientinnen im Vergleich zu historischen Serien bezüglich lokaler Kontrolle und Toxizität?
Simone Marnitz
Strahlentherapie und Onkologie.2017; 193(3): 236. CrossRef
CT-geplante HDR-Brachytherapie
Simone Marnitz-Schulze
InFo Onkologie.2017; 20(4): 10. CrossRef
Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
Jeanny Kwon, Keun-Yong Eom, In Ah Kim, Jae-Sung Kim, Young-Beom Kim, Jae Hong No, Kidong Kim
Cancer Research and Treatment.2016; 48(2): 632. CrossRef
A phase II study of postoperative concurrent carboplatin and paclitaxel combined with intensity-modulated pelvic radiotherapy followed by consolidation chemotherapy in surgically treated cervical cancer patients with positive pelvic lymph nodes
Seiji Mabuchi, Fumiaki Isohashi, Takeshi Yokoi, Masahiko Takemura, Kiyoshi Yoshino, Yasuhiko Shiki, Kimihiko Ito, Takayuki Enomoto, Kazuhiko Ogawa, Tadashi Kimura
Gynecologic Oncology.2016; 141(2): 240. CrossRef
Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer: A Comparison of 3DCRT, IMRT, and RapidARC
Yu Chang, Zhi-Yong Yang, Gui-Ling Li, Qin Li, Qin Yang, Ji-Quan Fan, Ying-Chao Zhao, Ying-Qiu Song, Gang Wu
International Journal of Gynecologic Cancer.2016; 26(4): 770. CrossRef
Randomized phase III trial of radiotherapy or chemoradiotherapy with topotecan and cisplatin in intermediate-risk cervical cancer patients after radical hysterectomy
Wenze Sun, Tao Wang, Fan Shi, Jiquan Wang, Juan Wang, Beina Hui, Yingbing Zhang, Jinli Lu, Hongwei Chen, Zi Liu
BMC Cancer.2015;[Epub] CrossRef
Time-window of early detection of response to concurrent chemoradiation in cervical cancer by using diffusion-weighted MR imaging: a pilot study
Ying Liu, Haoran Sun, Renju Bai, Zhaoxiang Ye
Radiation Oncology.2015;[Epub] CrossRef
Adjuvant chemotherapy after concurrent chemoradiation for locally advanced cervical cancer
Siriwan Tangjitgamol, Kanyarat Katanyoo, Malinee Laopaiboon, Pisake Lumbiganon, Sumonmal Manusirivithaya, Busaba Supawattanabodee
Cochrane Database of Systematic Reviews.2014;[Epub] CrossRef
Comparison of Clinical Efficacy of Three Different Neoadjuvant Approaches (Chemotherapy Combined Vaginal Intracavitary Irradiation, Neoadjuvant Chemotherapy Alone or Radiotherapy) Combined with Surgery for Patients with Stage Ib2 and IIa2 Cervical Cancer
Jian-Hong Fu, Zhan Gao, Chen-Chen Ren, Yong-Gang Shi
Asian Pacific Journal of Cancer Prevention.2013; 14(4): 2377. CrossRef
A Phase I Study of Concurrent Weekly Carboplatin and Paclitaxel Combined With Intensity-Modulated Pelvic Radiotherapy as an Adjuvant Treatment for Early-Stage Cervical Cancer Patients With Positive Pelvic Lymph Nodes
Seiji Mabuchi, Ryoko Takahashi, Fumiaki Isohashi, Takeshi Yokoi, Kimihiko Ito, Tateki Tsutui, Toshiyuki Ogata, Yasuo Yoshioka, Kazuhiko Ogawa, Tadashi Kimura
International Journal of Gynecologic Cancer.2013; 23(7): 1279. CrossRef

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The Increasing Frequency of Cervical Cancer in Korean Women under 35: Chan Hee Han, Hyun Jung Cho, Sung Jong Lee, Jeong Hoon Bae, Seog Nyen Bae, Sung Eun Namkoong, Jong Sup Park; Cancer Res Treat. 2008;40(1):1-5. Published online March 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.1.1

Abstract PDF PubReader ePub

Purpose

The goal of this study was to determine the clinical and epidemiological trends of cervical cancer in young Korean women. Social behavior including sexual habits has changed in Korean women, with sexual activity commencing at a younger age. These changes are likely to influence certain risk factors of cervical cancer, resulting in changing trends in the occurrence of the disease.

Materials and Methods

The incidence of cervical cancer in women less than 35 years-old between January 1990 and December 2006 was analyzed, and available medical records from January 1996 to December 2006 were reviewed. The clinical, pathological and epidemiologic characteristics and changing trends among these young patients were analyzed.

Results

Over the last two decades, the incidence of young (< 35 years) cervical cancer patients increased, more patients had an aggressive form of the disease, and there was a higher rate of women with more advanced education. Human papillomavirus (HPV) infection was detected in 94.0% of the women (63/67) tested. HPV 16 (82.5%) and HPV 18 (12.7%) were the two most common viral infections detected throughout the study period.

Conclusions

The changing trends and risk factors identified suggest a need for more active education of young women about cervical cancer prevention strategies. In addition, young women are strongly recommended to undergo a regular screening test and HPV vaccination.

Citations

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Prevalence and Treatment of Vulvar Cancer From 2014−2018: A Nationwide Population-Based Study in Korea
Yung-Taek Ouh, Dongwoo Kang, Hoseob Kim, Jae Kwan Lee, Jin Hwa Hong
Journal of Korean Medical Science.2022;[Epub] CrossRef
Successful Treatment of Synchronous Double Lung Primary Malignancies and Colon Cancer
Hosam A Alghanmi
Cureus.2022;[Epub] CrossRef
WITHDRAWN: Polymerase chain reaction technique for molecular detection of HPV16 infections among women with cervical cancer in Dhi-Qar Province
Abduladheem Turki Jalil, Ali Hussein Demin Al-Khafaji, Aleksandr Karevskiy, Saja Hussain Dilfy, Zaman K. Hanan
Materials Today: Proceedings.2021;[Epub] CrossRef
Current Status of Human Papillomavirus Infection and Introduction of Vaccination to the National Immunization Program in Korea: an Overview
Min-A Kim, Gwan Hee Han, Jae-Hoon Kim, Kyung Seo
Journal of Korean Medical Science.2018;[Epub] CrossRef
Management for locally advanced cervical cancer: new trends and controversial issues
Oyeon Cho, Mison Chun
Radiation Oncology Journal.2018; 36(4): 254. CrossRef
Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea
Eun-Kyeong Moon, Chang-Mo Oh, Young-Joo Won, Jong-Keun Lee, Kyu-Won Jung, Hyunsoon Cho, Jae Kwan Jun, Myong Cheol Lim, Moran Ki
Cancer Research and Treatment.2017; 49(2): 526. CrossRef
Factors associated with participation in cervical cancer screening among young Koreans: a nationwide cross-sectional study
Ha Kyun Chang, Jun-Pyo Myong, Seung Won Byun, Sung-Jong Lee, Yong Seok Lee, Hae-Nam Lee, Keun Ho Lee, Dong Choon Park, Chan Joo Kim, Soo Young Hur, Jong Sup Park, Tae Chul Park
BMJ Open.2017; 7(4): e013868. CrossRef
Molecular Detection and Typing of Human Papillomaviruses in Paraffin-Embedded Cervical Cancer and Pre-Cancer Tissue Specimens
Pezhman Mahmoodi, Hossein Motamedi, Masoud Reza Seyfi Abad Shapouri, Mahjabin Bahrami Shehni, Mohammad Kargar
Iranian Journal of Cancer Prevention.2016;[Epub] CrossRef
Cervical cancer in north-eastern Libya: 2000–2008
F. Ben Khaial, Z. Bodalal, A. Elramli, F. Elkhwsky, A. Eltaguri, R. Bendardaf
Journal of Obstetrics and Gynaecology.2014; 34(6): 523. CrossRef
Current status of the National Cancer Screening Program for cervical cancer in Korea, 2009
Young Hwa Lee, Kui Son Choi, Hoo-Yeon Lee, Jae Kwan Jun
Journal of Gynecologic Oncology.2012; 23(1): 16. CrossRef
Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study
J.-H. Nam, J.-Y. Park, D.-Y. Kim, J.-H. Kim, Y.-M. Kim, Y.-T. Kim
Annals of Oncology.2012; 23(4): 903. CrossRef
The safety of conization in the management of adenocarcinomain situof the uterine cervix
Mi-La Kim, Ho-Suap Hahn, Kyung-Taek Lim, Ki-Heon Lee, Hy-Sook Kim, Sung-Ran Hong, Tae-Jin Kim
Journal of Gynecologic Oncology.2011; 22(1): 25. CrossRef
Human papillomavirus 16/18 AS04-adjuvanted cervical cancer vaccine: immunogenicity and safety in 15-25 years old healthy Korean women
Seung Cheol Kim, Yong Sang Song, Young-Tae Kim, Young Tak Kim, Ki-Sung Ryu, Bhavyashree Gunapalaiah, Dan Bi, Hans L Bock, Jong-Sup Park
Journal of Gynecologic Oncology.2011; 22(2): 67. CrossRef
Prognostic value of metabolic tumor volume measured by FDG-PET/CT in patients with cervical cancer
Hyun Hoon Chung, Jae Weon Kim, Kyung Hee Han, Jae Seon Eo, Keon Wook Kang, Noh-Hyun Park, Yong-Sang Song, June-Key Chung, Soon-Beom Kang
Gynecologic Oncology.2011; 120(2): 270. CrossRef

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Assessment of Tumor Regression by Consecutive Pelvic Magnetic Resonance Imaging and Dose Modification during High-Dose-Rate Brachytherapy for Carcinoma of the Uterine Cervix: Taek-Keun Nam, Byung-Sik Nah, Ho-Sun Choi, Woong-Ki Chung, Sung-Ja Ahn, Seok-Mo Kim, Ju-Young Song, Mi-Seon Yoon; Cancer Res Treat. 2005;37(3):157-164. Published online June 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.3.157

Abstract PDF PubReader ePub

Purpose

To assess tumor regression, as determined by pelvic magnetic resonance imaging (MRI), and evaluate the efficacies and toxicities of the interim brachytherapy (BT) modification method, according to tumor regression during multi-fractionated high-dose-rate (HDR) BT for uterine cervical cancer.

Materials and Methods

Consecutive MRI studies were performed pre-radiotherapy (RT), pre-BT and during interfraction of BT (inter-BT) in 69 patients with cervical cancer. External beam radiotherapy (EBRT) was performed, using a 10 MV X-ray, in daily fraction of 1.8 Gy with 4-fields, 5 d/wk. Radiation was delivered up to 50.4 Gy, with midline shielding at around 30.6 Gy. Of all 69 patients, 50 received modified interim BT after checking the inter-BT MRI. The BT was delivered in two sessions; the first was composed of several 5 Gy fractions to point A, twice weekly, using three channel applicators. According to the three measured orthogonal diameters of the regressed tumor, based on inter-BT MR images, the initial BT plan was modified, with the second session consisting of a few fractions of less than 5 Gy to point A, using a cervical cylinder applicator.

Results

The numbers of patients in FIGO stages Ib, IIa, IIb and IIIb+IVa were 19 (27.5%), 18 (26.1%), 27 (39.2%) and 5 (7.2%), respectively. Our treatment characteristics were comparable to those from the literatures with respect to the biologically effective dose (BED) to point A, rectum and bladder as reference points. In the regression analysis a significant correlation was observed between tumor regression and the cumulative dose to point A on the follow-up MRI. Nearly 80% regression of the initial tumor volume occurred after 30.6 Gy of EBRT, and this increased to 90% after an additional 25 Gy in 5 fractions of BT, which corresponds to 73.6 Gy of cumulative BED₁₀ to point A. The median total fraction number, and those at the first and second sessions of BT were 8 (5~10), 5 (3~7) and 3 (1~5), respectively. The median follow-up time was 53 months (range, 9~66 months). The 4-year disease-free survival rate of all patients was 86.8%. Six (8.7%) patients developed pelvic failures, but major late complications developed in only two (2.9%).

Conclusion

Our study shows that effective tumor control, equivalent survival and low rates of major complications can be achieved by modifying the fraction size during BT according to tumor regression, as determined by consecutive MR images. We recommend checking the follow-up MRI at a cumulative BED₁₀ of around 65 Gy to point A, with the initial BT modified at a final booster BT session.

Citations

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Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
Florian Arend, Markus Oechsner, Clara B. Weidenbächer, Stephanie E. Combs, Kai J. Borm, Marciana N. Duma
Tumori Journal.2021; 107(2): 139. CrossRef
Target volume changes through high-dose-rate brachytherapy for cervical cancer when evaluated on high resolution (3.0 Tesla) magnetic resonance imaging
Wenqing Sun, Sudershan K. Bhatia, Geraldine M. Jacobson, Ryan T. Flynn, Yusung Kim
Practical Radiation Oncology.2012; 2(4): e101. CrossRef
Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [18F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography
Mee Sun Yoon, Sung-Ja Ahn, Byung-Sik Nah, Woong-Ki Chung, Ho-Chun Song, Su Woong Yoo, Ju-Young Song, Jae-Uk Jeong, Taek-Keun Nam
International Journal of Radiation Oncology*Biology*Physics.2012; 84(4): e491. CrossRef

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A Preliminary Results of a Randomized Trial Comparing Monthly 5-flourouracil and Cisplatin to Weekly Cisplatin Alone Combined with Concurrent Radiotherapy for Locally Advanced Cervical Cancer: Young Seok Kim, Seong Soo Shin, Eun Kyung Choi, Jong Hoon Kim, Seung Do Ahn, Sang-wook Lee, Heon-Jin Park, Young-Tak Kim, Jung-Eun Mok, Joo-Hyun Nam; Cancer Res Treat. 2005;37(1):37-43. Published online February 28, 2005; DOI: https://doi.org/10.4143/crt.2005.37.1.37

Abstract PDF PubReader ePub

Purpose

To determine the superior chemotherapeutic regimen between monthly 5-FU plus cisplatin (FP) and weekly cisplatin alone in concurrent chemoradiotherapy for locally advanced cervical cancer, the compliance of treatment, response, survival and toxicities were analyzed between the two arms.

Materials and Methods

Between March 1998 and December 2001, 61 patients with locally advanced cervical cancer (stage IIB through IVA) and negative para-aortic lymph nodes were randomly assigned to either 'monthly FP' (arm I, n=34) or 'weekly cisplatin' (arm II, n=27) with concurrent radiotherapy. The patients of arm I received FP (5-FU 1,000 mg/m²/day + cisplatin 20 mg/m²/day, for 5 days, for 3 cycles at 4 week intervals) and those of arm II received cisplatin (30 mg/m²/day, for 6 cycles at 1 week intervals) with concurrent radiotherapy. The radiotherapy consisted of 41.4~50.4 Gy external beam irradiation in 23~28 fractions to the whole pelvis, with high dose rate brachytherapy delivering a dose of 30~35 Gy in 6~7 fractions to point A. During the brachytherapy, a parametrial boost was delivered. The median follow-up period for survivors was 44 months.

Results

The compliance of treatment in monthly FP weekly cisplatin arms were 62 and 81%, respectively. The complete response rates at 3 months were 96 and 88% in arms I and II, respectively. The 4-year overall survival and disease free survival rates were 64 and 54% in the arm I and 77 and 66% in the arm II, respectively. The incidence of hematologic toxicity more than grade 2 was 29% in the arm I and 15% in the arm II. Only one patient in arm I experienced grade 3 gastrointestinal toxicity. No severe genitourinary toxicity was observed.

Conclusion

No significant difference was observed in the compliance, responses, survival rates and acute toxicities between the two treatment arms. More patients and further follow up will be required.

Citations

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Photogem Induces Necrosis in Various Uterine Cervical Cancer Cell Lines by PDT: Su Mi Bae, Seung Won Huh, Eun Kyung Park, Keun Ho Lee, Joon Mo Lee, Sung Eun Namkoong, Sei Jun Han, Chong Kook Kim, Jong Ki Kim, Yong Wan Kim, Woong Shick Ahn; Cancer Res Treat. 2003;35(6):549-556. Published online December 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.6.549

Abstract PDF

PURPOSE
In order to elucidate the antitumor effect of photodynamic therapy (PDT), using a derivative of the photosensitizing agent hematoporphyrin (Photogem) and a diode laser, the cell death of uterine cancer cell lines (CaSki, HT3, HeLa, and SKOV-3), and mice transplanted with TC-1 lung cancer cells, were evaluated. MATERIALS AND METHODS: The morphological changes, MTT assay, flow cytometry, cytotoxicity and tumor growth inhibition study were evaluated at various time intervals after the PDT.
RESULTS
The results showed that the survival rates of each cell line decreased with time and dose response after performing the PDT. Also, the PDT-induced damage of cancer cells was almost entirely confined to necrosis of the tumor cells in the early time courses. The irradiation of CaSki cells in the presence of Photogem induced plasma membrane disruption and cell shrinkage, indicating the plasma membrane as the main target for Photogem. In the in vivo experiment, significantly longer survival and a significantly smaller tumor size were seen over the time courses of the Photogem with irradiation compared to the untreated control groups; resorption of the tumor was also observed after the PDT treatment. CONCLUSION: Collectively, our results indicated that Photogem possesses anti-tumor effects, and necrosis-like death, with plasma membrane damage, was postulated to be the principal mechanism of the antitumor effect of the PDT using Photogem.

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Cancer Research and Treatment.2004; 36(6): 389. CrossRef

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