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Na J, Li Y, Wang J, Wang X, Lu J, Han S. The correlation between multiple HPV infections and the occurrence, development, and prognosis of cervical cancer. Front Microbiol 2023; 14:1220522. [PMID: 37577444 PMCID: PMC10416435 DOI: 10.3389/fmicb.2023.1220522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Cervical carcinoma is the fourth female malignant tumor in the world, and the persistent infection of high-risk human papillomavirus (HPV) is recognized as the most common cause. This article studies the correlation between multiple HPV infections and the occurrence, development, and prognosis of cervical cancer in order to provide more references for clinical diagnosis and treatment. We conducted a retrospective analysis of the clinical data of 400 cervical carcinoma patients admitted to our hospital from 2015 to 2023. The collected patient data include age, HPV infection status, tumor size and morphology, local infiltration depth, diagnostic staging, surgical approach, vascular cancer thrombus status, lymph node status, and postoperative HPV follow-up status. We use SPSS statistical software for data analysis. Our research shows that the high-risk age group for cervical carcinoma is concentrated between 41 and 60 years old, which is basically consistent with the age range of the high incidence of HPV infection. In the statistics for HPV infection types, ~67.7% of patients are single HPV-infected, 25.29% are double infected, and 7.00% are infected with three or more types of HPV. Among the multiple HPV infections, most of the patients are younger than 40 years old and older than 70 years old, with double infection accounting for the majority. The top five HPV subtypes with high detection rates belong to high-risk subtypes, which are the HPV16, 18, 58, 33, and 52 subtypes, respectively. There was no significant relationship between multiple HPV infections and cervical cancer stage, lesion size, pathological tissue type, tissue differentiation degree/vascular cancer thrombus, and lymph node metastasis, and there was no significant difference in the results between the groups. In summary, multiple types of HPV infection in the cervix are common. We found that multiple infections, mainly HPV16, are closely related to cervical cancer. For the HPV16, 18, 58, 33, and 52 subtypes of infection, especially for patients younger than 40 years old and older than 70 years old, priority should be given to prevention and treatment. The relationship between multiple HPV infections and the progression and prognosis of cervical carcinoma requires further research, which could better guide cancer prevention and treatment.
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Affiliation(s)
| | | | | | | | - JunLing Lu
- Department of Gynecology and Obstetrics, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shichao Han
- Department of Gynecology and Obstetrics, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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2
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Cho WK, Kim HS, Park W, Chang CS, Lee YY, Choi CH, Kim TJ, Lee JW, Kim BG. Predicting prognosis according to the updated WHO classification in patients with endocervical adenocarcinoma treated with surgery and radiotherapy. J Gynecol Oncol 2022; 33:e71. [PMID: 36047374 DOI: 10.3802/jgo.2022.33.e71] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/04/2022] [Accepted: 07/10/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The recently updated World Health Organization classification divides endocervical adenocarcinomas (ADCs) into human papillomavirus (HPV)-associated (HPVA) and HPV-independent (HPVI) ADCs. This study aimed to investigate the differences in the clinical features and treatment outcomes between patients with HPVA and HPVI. METHODS We retrospectively reviewed the electronic medical records and pathology slides of 123 patients with endocervical ADC who underwent radical hysterectomy and adjuvant radiation therapy. Tumor characteristics, patterns of failure, and survival outcomes were compared between HPVA and HPVI ADCs. RESULTS Eighty-one (65.9%) and 42 (34.1%) patients were diagnosed with HPVA and HPVI ADCs, respectively. HPVI ADC showed more frequent positive vaginal resection margin (VRM) and peritoneal seeding than HPVA ADC. After a median follow-up of 58.1 months, local recurrence and distant metastasis were more frequently observed in HPVI ADC than in HPVA ADC. Both local recurrence-free survival (77.3% vs. 91.8%) and distant metastasis-free survival (50.1% vs. 73.7%) rates of HPVI ADC were lower than those of HPVA ADC. Disease-free survival was not significantly different between HPVI and HPVA ADCs. CONCLUSION We demonstrated that HPVI ADC exhibited higher rates of VRM involvement and peritoneal seeding than those of HPVA ADC, resulting in higher rates of local recurrence and distant metastasis. Further studies with larger populations are warranted to explore optimal treatment strategies based on the histological subtypes of endocervical ADC.
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Affiliation(s)
- Won Kyung Cho
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Chi-Son Chang
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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3
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Li B, Shou Y, Zhu H. Predictive value of hemoglobin, platelets, and D-dimer for the survival of patients with stage IA1 to IIA2 cervical cancer: a retrospective study. J Int Med Res 2021; 49:3000605211061008. [PMID: 34939884 PMCID: PMC8725234 DOI: 10.1177/03000605211061008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective Coagulation indexes may be useful survival biomarkers for cervical cancer.
This study evaluated the ability of hemoglobin, red blood cells (RBCs),
platelets, and D-dimer levels to predict post-hysterectomy survival outcomes
in patients with stage IA1 to IIA2 cervical cancer. Methods In this retrospective study, coagulation-related indexes were compared
between the anemia and non-anemia groups. Independent variables were
analyzed by the Cox proportional hazards model. Survival was assessed by the
Kaplan–Meier method with the log-rank test. Mortality predictions were
evaluated by receiver operating characteristic curves. Results Among this study’s 1088 enrolled patients, 152 had anemia. The 10-year
overall survival and recurrence-free survival rates were 90.8% and 86.5%,
respectively. Hemoglobin, RBC, and the rate of abnormal platelet counts were
significantly lower in the anemia group. Abnormal preoperative D-dimer was
an independent factor for recurrence-free survival. Receiver operating
characteristic curves showed that D-dimer had area under the curve of 0.734
(cut-off value: 0.685, sensitivity: 85.7%, and specificity: 64.0%).
Hemoglobin and platelets had areas under the curves of 0.487 and 0.462,
respectively. Conclusion Preoperative D-dimer was the most effective prognostic predictor for patients
with cervical cancer. The prognosis of patients with cervical cancer was
poorer if their D-dimer levels were >0.685 mg/L.
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Affiliation(s)
- Bilan Li
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yueyao Shou
- Department of Gynecology, 89657The First Affiliated Hospital of Wenzhou Medical University, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haiyan Zhu
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Gynecology, 89657The First Affiliated Hospital of Wenzhou Medical University, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Ruiz FJ, Inkman M, Rashmi R, Muhammad N, Gabriel N, Miller CA, McLellan MD, Goldstein M, Markovina S, Grigsby PW, Zhang J, Schwarz JK. HPV transcript expression affects cervical cancer response to chemoradiation. JCI Insight 2021; 6:e138734. [PMID: 34255749 PMCID: PMC8409981 DOI: 10.1172/jci.insight.138734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/07/2021] [Indexed: 12/24/2022] Open
Abstract
Persistent HPV infection is causative for the majority of cervical cancer cases; however, current guidelines do not require HPV testing for newly diagnosed cervical cancer. Using an institutional cohort of 88 patients with cervical cancer treated uniformly with standard-of-care chemoradiation treatment (CRT) with prospectively collected clinical outcome data, we observed that patients with cervical tumors containing HPV genotypes other than HPV 16 have worse survival outcomes after CRT compared with patients with HPV 16+ tumors, consistent with previously published studies. Using RNA sequencing analysis, we quantified viral transcription efficiency and found higher levels of E6 and the alternative transcript E6*I in cervical tumors with HPV genotypes other than HPV 16. These findings were validated using whole transcriptome data from The Cancer Genome Atlas (n = 304). For the first time to our knowledge, transcript expression level of HPV E6*I was identified as a predictive biomarker of CRT outcome in our complete institutional data set (n = 88) and within the HPV 16+ subset (n = 36). In vitro characterization of HPV E6*I and E6 overexpression revealed that both induce CRT resistance through distinct mechanisms dependent upon p53–p21. Our findings suggest that high expression of E6*I and E6 may represent novel biomarkers of CRT efficacy, and these patients may benefit from alternative treatment strategies.
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Affiliation(s)
- Fiona J Ruiz
- Department of Radiation Oncology.,Division of Biological and Biomedical Sciences Molecular Cell Biology
| | - Matthew Inkman
- Department of Radiation Oncology.,Institute for Informatics
| | | | | | | | | | | | | | | | - Perry W Grigsby
- Department of Radiation Oncology.,Alvin J. Siteman Cancer Center.,Division of Nuclear Medicine, Mallinckrodt Institute, and
| | - Jin Zhang
- Department of Radiation Oncology.,Institute for Informatics.,Alvin J. Siteman Cancer Center
| | - Julie K Schwarz
- Department of Radiation Oncology.,Alvin J. Siteman Cancer Center.,Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Diefenbach D, Greten HJ, Efferth T. Genomic landscape analyses in cervical carcinoma and consequences for treatment. Curr Opin Pharmacol 2020; 54:142-157. [PMID: 33166910 DOI: 10.1016/j.coph.2020.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 11/28/2022]
Abstract
Where we are on the road to 'tailor-made' precision medicine for drug-resistant cervical carcinoma? We explored studies about analyses of viral and human genomes, epigenomes and transcriptomes, DNA mutation analyses, their importance in detecting HPV sequences, mechanisms of drug resistance to established and targeted therapies with small molecule or therapeutic antibodies, to radiosensitivity and to chemoradiotherapy. The value of repurposing of old drugs initially approved for other disease indications and now considered for cervix cancer therapy is also discussed. The microbiome influences drug response and survival too. HPV genomic integration sites were less significant. Nomograms (Lee et al., 2013) even outperformed FIGO staging regarding prediction of five-year overall survival times. We conclude that there are still many loose threads to be followed up, before coherent conclusions for individualized therapy of drug-resistant cervical carcinoma can be drawn.
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Affiliation(s)
- Dominik Diefenbach
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | | | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany.
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Gennigens C, De Cuypere M, Seidel L, Hermesse J, Barbeaux A, Forget F, Albert A, Jerusalem G, Kridelka F. Correlation between hematological parameters and outcome in patients with locally advanced cervical cancer treated by concomitant chemoradiotherapy. Cancer Med 2020; 9:8432-8443. [PMID: 32954675 PMCID: PMC7666723 DOI: 10.1002/cam4.3465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 01/28/2023] Open
Abstract
Background Hemoglobin (Hb), white blood cell (WBC), and polymorphonuclear neutrophil (PMN) blood counts may be correlated with outcomes in patients with locally advanced cervical cancer. Methods Hb, WBC, and PMN counts were measured at diagnosis and during concomitant cisplatin‐based chemoradiotherapy (CCRT) in a retrospective sample of 103 patients between 2010 and 2017. Red blood cell (RBC) transfusions were also recorded. The associations between hematological variables and patient overall survival (OS) and recurrence‐free survival (RFS) were assessed by Cox regression models. Results The 3‐year OS and RFS rates were 81.4% and 76.8%, respectively. In addition to tumor size and smoking, OS and RFS were found to be significantly associated with changes in WBC and PMN counts from the first to the last cisplatin cycle. Hb count throughout the treatment and RBC transfusions were not predictive of outcome. Conclusions This study found no association between Hb count or RBC transfusions and outcome. The daily practice of maintaining the Hb count above 12 g/dL during CCRT should be weighed against the potential risks of transfusions. Drops in WBC and PMN counts during treatment positively impacted OS and RFS and could, therefore, serve as biomarkers during CCRT to adapt the follow‐up and consider the need for adjuvant systemic treatments.
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Affiliation(s)
| | | | - Laurence Seidel
- Department of Biostatistics, CHU Liège and Liège University, Liège, Belgium
| | | | | | - Frédéric Forget
- Department of Medical Oncology, Libramont Hospital, Libramont, Belgium
| | - Adelin Albert
- Department of Biostatistics, CHU Liège and Liège University, Liège, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, CHU Liège and Liège University, Liège, Belgium
| | - Frédéric Kridelka
- Department of Obstetrics and Gynaecology, CHU Liège and Liège University, Liège, Belgium
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Pokrývková B, Saláková M, Šmahelová J, Vojtěchová Z, Novosadová V, Tachezy R. Detailed Characteristics of Tonsillar Tumors with Extrachromosomal or Integrated Form of Human Papillomavirus. Viruses 2019; 12:v12010042. [PMID: 31905862 PMCID: PMC7019694 DOI: 10.3390/v12010042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/22/2019] [Accepted: 12/26/2019] [Indexed: 12/14/2022] Open
Abstract
The human papillomavirus (HPV) integration, the critical step in viral carcinogenesis, most frequently occurs in the E2 gene, which results in its inactivation and in an increase of E6/E7 transcription. However, in a substantial number of tumors, the virus is present in an extrachromosomal form. For those tumors, the transformation mechanisms are not fully elucidated. Here we evaluated the possible mechanism of inactivating the E2 without interruption of the gene, methylation or mutation of the E2 binding sites (E2BSs) in HPV16-positive tonsillar tumors by next-generation and Sanger sequencing. Viral genome status was analyzed by the amplification of papillomavirus oncogene transcripts assay (APOT) and mRNA mapping, and expression of viral oncogenes was performed by qPCR. The methylation of E2BSs was significantly higher in tumors with an integrated, in comparison to extrachromosomal, form of the viral genome. No mutations were detected in the E2BSs. The viral oncogenes were equally expressed in samples with an integrated and extrachromosomal form of the virus. Only the nucleotide variants were identified in the E2 gene. No proposed mechanism of E2 inactivation was confirmed in tonsillar tumors with an extrachromosomal form of the HPV genome. The expression of E6/E7 genes seems to be sufficient to initiate and maintain the carcinogenic process.
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Affiliation(s)
- Barbora Pokrývková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic; (B.P.); (J.Š.); (Z.V.); (R.T.)
| | - Martina Saláková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic; (B.P.); (J.Š.); (Z.V.); (R.T.)
- Correspondence: ; Tel.: +42-032-587-3920
| | - Jana Šmahelová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic; (B.P.); (J.Š.); (Z.V.); (R.T.)
| | - Zuzana Vojtěchová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic; (B.P.); (J.Š.); (Z.V.); (R.T.)
| | - Vendula Novosadová
- Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic;
| | - Ruth Tachezy
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Průmyslová 595, 25250 Vestec, Czech Republic; (B.P.); (J.Š.); (Z.V.); (R.T.)
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Wang Y, Ouyang Y, Su J, Liu J, Cai Q, Xu Q, Bai Z, Cao X. Multicentre, randomised controlled trial of adjuvant chemotherapy in cervical cancer with residual human papilloma virus DNA following primary radiotherapy or chemoradiotherapy: a study protocol. BMJ Open 2019; 9:e028171. [PMID: 31594870 PMCID: PMC6797403 DOI: 10.1136/bmjopen-2018-028171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The role of adjuvant chemotherapy after radical radiotherapy (RT) or chemoradiotherapy (CRT) in cervical cancer awaits further confirmation. Evidences have shown that persistent human papilloma virus (HPV) DNA in exfoliated cell post-RT is a potential biomarker of subclinical residual disease and thus increases the risk of recurrence. In this prospective, multicentre, randomised controlled trial, we will use HPV DNA in exfoliated cell to identify patients with cervical cancer who received definitive RT or CRT with higher risk of relapse for adjuvant chemotherapy. METHODS AND ANALYSIS Eligible patients with histologically confirmed cervical cancer stage IIA2 to IVA of the International Federation of Gynaecology and Obstetrics, adequate organ function and no locoregional disease or distant metastasis after completion of primary treatment will be screened for HPV DNA in exfoliated cell at 1 month post-RT. Patients with undetectable HPV DNA will undergo standard surveillance. Patients with detectable HPV DNA will be randomly assigned to either adjuvant chemotherapy with docetaxel and nedaplatin for four cycles (arm 1) or observation (arm 2). Patients will be stratified for primary treatment (RT vs CRT). The primary endpoint is relapse-free survival. ETHICS AND DISSEMINATION This protocol received a favourable ethical opinion from the Ethics Committee of the Second Affiliated Hospital of Fujian Medical University on 6 February, 2018, (No. 28). The trial results will be published in peer-reviewed journals and presented in conferences. A summary of the findings will be made available to participants. TRIAL REGISTRATION NUMBER ChiCTR-IIR-17012655; Pre-results.
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Affiliation(s)
- Yanhong Wang
- Radiotherapy Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi Ouyang
- Radiotherapy Department, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jingjing Su
- Radiotherapy Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jing Liu
- Gynecology Department, Fujian Provincial Tumor Hospital, Fuzhou, China
| | - Qunrong Cai
- Radiotherapy Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qin Xu
- Gynecology Department, Fujian Provincial Tumor Hospital, Fuzhou, China
| | - Zhigang Bai
- Radiotherapy Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xinping Cao
- Radiotherapy Department, Sun Yat-sen University Cancer Center, Guangzhou, China
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Joo J, Omae Y, Hitomi Y, Park B, Shin HJ, Yoon KA, Sawai H, Tsuiji M, Hayashi T, Kong SY, Tokunaga K, Kim JY. The association of integration patterns of human papilloma virus and single nucleotide polymorphisms on immune- or DNA repair-related genes in cervical cancer patients. Sci Rep 2019; 9:13132. [PMID: 31511581 PMCID: PMC6739467 DOI: 10.1038/s41598-019-49523-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 08/24/2019] [Indexed: 11/24/2022] Open
Abstract
The present study investigated the association between single nucleotide polymorphisms (SNPs) in immune- or DNA repair-related genes and the integration pattern of human papillomavirus (HPV), a promising prognostic marker in cervical cancer. The HPV integration patterns of cervical cancer patients were determined by polymerase chain reaction and in situ hybridization, and categorized as episomal (group A), single-copy or multi-copy tandem repetition integrated (group B), and undetectable HPV types (group C). After sample and SNP quality control, 166,505 SNPs in 161 samples (38, 111, and 12 patients in groups A, B, and C, respectively) were examined. None of the SNPs reached genome-wide significance, and several candidate SNPs for future study were selected, including rs10999435 on chromosome 10q22, rs1322054 on chromosome 9q32-33, and rs10902171 on chromosome 11p15. Luciferase assay identified rs1322054 as the primary functional variant to regulate gene expression in immune cell. Further studies are needed to determine the genetic background of different integration patterns of HPV in cervical cancer patients.
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Affiliation(s)
- Jungnam Joo
- Biometrics Research Branch, National Cancer Center, Goyang, Korea
| | - Yosuke Omae
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Genome Medical Science Project (Toyama), National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Yuki Hitomi
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Microbiology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo, Japan
| | - Boram Park
- Biometrics Research Branch, National Cancer Center, Goyang, Korea
| | - Hye-Jin Shin
- Particle Therapy Research Branch, National Cancer Center, Goyang, Korea
| | - Kyong-Ah Yoon
- College of Veterinary Medicine, Konkuk University, Seoul, Korea
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Hiromi Sawai
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Makoto Tsuiji
- Department of Microbiology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo, Japan
| | - Tomonori Hayashi
- Department of Radiobiology and Molecular Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Sun-Young Kong
- Translational Research Branch, National Cancer Center, Goyang, Korea
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Genome Medical Science Project (Toyama), National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Joo-Young Kim
- Particle Therapy Research Branch, National Cancer Center, Goyang, Korea.
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Cho O, Chun M. Management for locally advanced cervical cancer: new trends and controversial issues. Radiat Oncol J 2018; 36:254-264. [PMID: 30630264 PMCID: PMC6361251 DOI: 10.3857/roj.2018.00500] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/17/2018] [Indexed: 01/21/2023] Open
Abstract
This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.
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Affiliation(s)
- Oyeon Cho
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
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Ma JY, Ke LC, Liu Q. The pretreatment platelet-to-lymphocyte ratio predicts clinical outcomes in patients with cervical cancer: A meta-analysis. Medicine (Baltimore) 2018; 97:e12897. [PMID: 30412089 PMCID: PMC6221620 DOI: 10.1097/md.0000000000012897] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION The platelet-to-lymphocyte ratio (PLR) has been reported to possess significant prognostic value in multiple types of cancer. However, its prognostic value in patients with cervical remains controversial. We conducted a meta-analysis to evaluate the prognostic value of pretreatment PLR in cervical cancer. METHODS We searched the MEDLINE, EMBASE, and Cochrane databases to identify studies evaluating the prognostic significance of the pretreatment PLR in patients with cervical cancer. The end points were overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and clinicopathological parameters. All statistical analyses were conducted with Stata 13.0. RESULTS A total of 12 studies comprising 3668 patients with cervical cancer were included. Elevated PLR was significantly correlated with poor OS [hazard ratio (HR): 1.56, 95% confidence interval (CI): 1.32-1.85, P < .001] and DFS/PFS (HR = 1.56; 95% CI = 1.26-1.94; P < .001). In addition, elevated PLR was highly correlated with lymphovascular space invasion (+), lymph node metastasis (+), tumor size (>4 cm), grade (G3). CONCLUSION The pretreatment PLR could serve as a predicative biomarker of poor prognosis for patients with cervical cancer.
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