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Schulte JJ, Lastra RR. Abdominopelvic washings in gynecologic pathology: A comprehensive review. Diagn Cytopathol 2016; 44:1039-1057. [DOI: 10.1002/dc.23569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 08/09/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Jefree J. Schulte
- Department of Pathology; The University of Chicago; Chicago Illinois
| | - Ricardo R. Lastra
- Department of Pathology; The University of Chicago; Chicago Illinois
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Nakamura K, Kitahara Y, Satoh T, Takei Y, Takano M, Nagao S, Sekiguchi I, Suzuki M. Analysis of the effect of adjuvant radiotherapy on outcomes and complications after radical hysterectomy in FIGO stage IB1 cervical cancer patients with intermediate risk factors (GOTIC Study). World J Surg Oncol 2016; 14:173. [PMID: 27356862 PMCID: PMC4928324 DOI: 10.1186/s12957-016-0931-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 06/23/2016] [Indexed: 11/23/2022] Open
Abstract
Background There are no definitive criteria for identifying which patients with The International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer will benefit from adjuvant therapy after radical hysterectomy. The aims of this study were to clarify the efficacy of adjuvant therapy and assess complications after radical hysterectomy in patients with FIGO stage IB1 cervical cancer with intermediate risk factors. Methods Between January 2005 and December 2009, the medical records of 75 stage IB1 patients’ intermediate risk factors (i.e., tumor size 2–4 cm, lymphovascular involvement, and/or deep stromal invasion >1/2) who underwent radical hysterectomy at six institutions were collected, and these patients were enrolled in this nonrandomized retrospective study. We simplified the criteria of intermediate risk factors as much as possible, as the criteria adopted in some clinical studies are complicated in practice. Results The patients were grouped according to the receipt of adjuvant therapy as follows: 46 patients, no further treatment; 19 patients, external beam radiation treatment, including 9 patients who received brachytherapy; 5 patients, concurrent chemoradiotherapy (CCRT); and 5 patients, chemotherapy (CT). The clinical outcomes and complications in each group were analyzed. After an average follow-up of 82.6 months (range, 24–135 months), only one patient with all three risk factors who received radiotherapy (RT) experienced recurrence. Excluding this patient, the remaining patients who received RT, CCRT, or CT had two or three risk factors. Lymphedema was significantly more common among patients who received RT or CCRT, whereas the incidence of ileus and ureteral obstruction was not different among the treatment groups. However, an unsutured peritoneum increased the risk of ileus. Conclusions The findings of this study suggest that RT and CCRT after radical hysterectomy are not beneficial in patients with intermediate risk factors. In particular, RT and CCRT appeared to increase the incidence of lymphedema. A prospective randomized study is needed to verify the findings of this study.
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Affiliation(s)
- Kazuto Nakamura
- Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma, 371-8511, Japan. .,Current address: Department of Gynecology, Gunma Cancer Center, Ota, Gunma, 373-8550, Japan.
| | - Yoshikazu Kitahara
- Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma, 371-8511, Japan
| | - Toyomi Satoh
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yuji Takei
- Department of Obstetrics and Gynecology, Jichi Medical University Hospital, Shimotsuke, Tochigi, 329-0498, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan
| | - Shoji Nagao
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, 350-1298, Japan.,Current address: Department of Gynecology, Hyogo Cancer Center, Akashi, Hyogo, 673-8558, Japan
| | - Isao Sekiguchi
- Department of Gynecology, Tochigi Cancer Center, Utusnomiya, Tochigi, 320-0834, Japan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University Hospital, Shimotsuke, Tochigi, 329-0498, Japan
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Li J, Wu MF, Lu HW, Chen Q, Lin ZQ, Wang LJ. Pretreatment serum lactate dehydrogenase is an independent prognostic factor for patients receiving neoadjuvant chemotherapy for locally advanced cervical cancer. Cancer Med 2016; 5:1863-72. [PMID: 27350066 PMCID: PMC4971915 DOI: 10.1002/cam4.779] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/31/2016] [Accepted: 04/29/2016] [Indexed: 11/15/2022] Open
Abstract
For locally advanced cervical cancer (LACC), hypoxia is a characteristic property. This study aimed to investigate whether baseline lactic dehydrogenase (LDH) level, which is a marker of hypoxia, had clinical value in determining neoadjuvant chemotherapy (NACT) response and prognosis for LACC patients. The study cohort included 418 patients with a median follow‐up of 37.5 months. Cox proportional hazards models were used to assess the prognostic value of baseline LDH levels. Multivariate logistic regression analysis was performed to identify independent predictors of complete response after NACT. Backward stepwise selection with the Akaike information criterion was used to identify factors that could be entered into the multivariate regression model. Compared with patients with LDH levels <252.0 μ/L, patients with LDH levels ≥252.0 μ/L were more likely to have an elevated level of squamous cell carcinoma antigen, lymphatic vascular space involvement, lymph node metastasis, and positive parametrium and achieved lower complete remission rates. Baseline LDH levels ≥252.0 μ/L was an independent prognosticator for recurrence‐free survival (adjusted hazard ratio [HR], 3.56; 95% confidence interval [CI] 2.22–5.69; P < 0.0001) and cancer‐specific survival (adjusted HR, 3.08; 95% CI, 1.89–5.01; P < 0.0001). The predictive value of baseline LDH value remained significant in the subgroup analysis. LDH level ≥252.0 μ/L was identified as an independent predictor of complete remission after NACT (adjusted odds ratio [OR], 0.29; 95% CI, 0.15–0.58; P < 0.0001). Baseline LDH ≥252.0 μ/L is an independent prognostic predictor for patients receiving neoadjuvant chemotherapy for LACC. It helps distinguish patients with different prognosis and select patients who are more likely to benefit from NACT.
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Affiliation(s)
- Jing Li
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Team-Based Learning Group of Clinical Study, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Miao-Fang Wu
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Huai-Wu Lu
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Qing Chen
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhong-Qiu Lin
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Li-Juan Wang
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
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Tortora M, Annunziata C, Liguori G, Losito S, Botti G, Greggi S, Buonaguro L, Buonaguro FM, Tornesello ML. Detection of human papillomavirus DNA in peri-tumor tissues and pelvic lymph nodes as potential molecular marker of micrometastasis in cervical cancer. Infect Agent Cancer 2016; 11:22. [PMID: 27175213 PMCID: PMC4863320 DOI: 10.1186/s13027-016-0068-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/01/2016] [Indexed: 12/20/2022] Open
Abstract
Background The association between high risk human papillomaviruses (HPV) and cervical cancer has been firmly established. HPV genome is present in nearly all cases of cervical cancer and detection of viral DNA could therefore be used as a surrogate marker of micrometastasis in peri-tumor tissues and lymph nodes. Methods We analyzed primary cervical carcinomas, peri-tumor biopsies and pelvic lymph nodes in 20 women with invasive cancer (FIGO stage I-II) who underwent radical pelvic surgery and lymphadenectomy. HPV DNA was searched by broad spectrum PCR in 142 DNA samples extracted from paraffin embedded tissues. Viral genotypes were identified by direct sequencing analysis. Results HPV DNA sequences were identified in all available primary cervical tumors (n = 15). The most common genotype was HPV16 (60 %), followed by HPV18 (20 %), HPV35 (7 %), HPV45 (7 %) and HPV66 (7 %). Seven out of 20 (35 %) women had metastatic spread in peri-tumor tissues and/or lymph nodes, as determined by histology. HPV DNA was detected in all histological positive samples as well as in 16 and 25 % of histological negative peri-tumor tissues and lymph nodes, respectively. Three out of 20 (15 %) women without histological evidence of metastatic spread had HPV-positive lymph nodes. HPV genotype was found always concordant between primary tumor and metastatic lesions. The remaining 10 women (50 %) were histology and HPV-negative in all peri-tumor biopsies and lymph nodes analyzed. Conclusions Evaluation of HPV DNA in peri-tumor tissues as well as pelvic lymph nodes could be a sensitive marker to identify micrometastasis or isolated tumor cells and to monitor the risk of disease recurrence in women with cervical cancer.
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Affiliation(s)
- Marianna Tortora
- Molecular Biology and Viral Oncology Division, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, 80131 Napoli, Italy
| | - Clorinda Annunziata
- Molecular Biology and Viral Oncology Division, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, 80131 Napoli, Italy
| | - Giuseppina Liguori
- Department of Pathology, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, Napoli, 80131 Italy
| | - Simona Losito
- Department of Pathology, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, Napoli, 80131 Italy
| | - Gerardo Botti
- Department of Pathology, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, Napoli, 80131 Italy
| | - Stefano Greggi
- Division of Gynecology, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, Napoli, 80131 Italy
| | - Luigi Buonaguro
- Molecular Biology and Viral Oncology Division, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, 80131 Napoli, Italy
| | - Franco M Buonaguro
- Molecular Biology and Viral Oncology Division, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, 80131 Napoli, Italy
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology Division, Istituto Nazionale Tumori "Fond. Pascale" - IRCCS, 80131 Napoli, Italy
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