1
|
Shu X, Zhou Y, Wei G, Chen X, Qiu M. Cervical Carcinosarcoma: Current Understanding on Pathogenesis, Diagnosis, Management and Future Perspectives. Clin Med Insights Oncol 2022; 15:11795549211056273. [PMID: 35153524 PMCID: PMC8826264 DOI: 10.1177/11795549211056273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/10/2021] [Indexed: 02/05/2023] Open
Abstract
Cervical carcinosarcoma (CCS) is a rare aggressive tumor which was referred to as
a sarcoma initially with its morbidity less than 1% of all cervical cancers.
Four theories have been proposed for the pathogenesis of CCS. The “metaplastic
theory,” also called “monoclonal theory,” has been widely accepted so far. The
most common clinical symptom of CCS is abnormal vaginal bleeding. CCS is much
less common than the counterparts in uterine corpus and usually confused with
uterine carcinosarcoma (UCS) or common cervical cancer. The management for CCS
has been mainly extrapolated from studies of UCS or cervical cancers. However,
CCS has its special anatomical position and biological behaviors and is usually
diagnosed at an early stage than UCS. Currently, there is no consensus on the
survival, management and prognosis factors of CCS. We reviewed and summarized
the literatures regarding to the epidemiology, clinical presentations,
pathogenesis, diagnosis and treatment of CCS for providing clinicians with
comprehensive information to diagnose and treat this malignancy.
Collapse
Affiliation(s)
- Xinyao Shu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuwen Zhou
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Guixia Wei
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaorong Chen
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Qiu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Shiba S, Oike T, Ando K, Yoshimoto Y, Takayama Y, Ohno T. Granulocyte-colony stimulating factor-producing uterine cervical cancer treated with chemoradiotherapy: A case report with mutation analysis and literature review. Clin Case Rep 2021; 9:185-192. [PMID: 33489157 PMCID: PMC7812995 DOI: 10.1002/ccr3.3495] [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] [Received: 04/09/2020] [Accepted: 07/22/2020] [Indexed: 12/09/2022] Open
Abstract
Granulocyte-colony stimulating factor-producing uterine cervical cancer is a rare aggressive disease, which may be genetically distinct from other uterine cervical cancers.
Collapse
Affiliation(s)
- Shintaro Shiba
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiJapan
- Gunma University Heavy Ion Medical CenterMaebashiJapan
| | - Takahiro Oike
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiJapan
- Gunma University Heavy Ion Medical CenterMaebashiJapan
| | - Ken Ando
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiJapan
| | - Yuya Yoshimoto
- Department of Radiation Oncology, School of MedicineFukushima Medical UniversityHikarigaokaJapan
| | | | - Tatsuya Ohno
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiJapan
| |
Collapse
|
3
|
Combined PLT and NE to predict the prognosis of patients with locally advanced cervical cancer. Sci Rep 2020; 10:11210. [PMID: 32641736 PMCID: PMC7343858 DOI: 10.1038/s41598-020-66387-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/11/2020] [Indexed: 12/26/2022] Open
Abstract
Cervical cancer is one of the most common tumors in women. Neutrophils (NEs) and platelets (PLTs) are components of cells in circulating blood. NEs are one of the components of white blood cells (WBCs), accounting for the vast majority of WBCs, recognized as one of the indicators of inflammation. PLTs are associated with thrombosis and inflammation. Both of them play an important role in tumor growth and metastasis. According to pre-radiotherapy PLT and NE media levels, we divided the patients into three groups: PLT and NE both high levels group, single high level group and both low group. By using COX regression models and nomogram, a prognostic model for patients was established. Both high levels of pre-radiotherapy PLT and NE group or high levels of post-radiotherapy PLT and NE group were correlated with worst overall survival (OS) compared with the other two groups. PLT and NE were correlated with outcomes of the patients with locally advanced cervical cancer.
Collapse
|
4
|
Kikuchi T, Kato J, Koda Y, Sakurai M, Hayashi Y, Mori T. Safe administration of granulocyte colony-stimulating factor (G-CSF) to a patient with G-CSF-producing multiple myeloma. Ann Hematol 2020; 99:1667-1668. [PMID: 32504185 DOI: 10.1007/s00277-020-04120-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Taku Kikuchi
- Department of Medicine, Division of Hematology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Jun Kato
- Department of Medicine, Division of Hematology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuya Koda
- Department of Medicine, Division of Hematology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masatoshi Sakurai
- Department of Medicine, Division of Hematology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuichiro Hayashi
- Department of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan
| | - Takehiko Mori
- Department of Medicine, Division of Hematology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| |
Collapse
|
5
|
Zhu J, Wang H, Gao MJ, Li YF, Huang YQ, Shi JP, Wang WJ. Prognostic values of lymphocyte and eosinophil counts in resectable cervical squamous cell carcinoma. Future Oncol 2019; 15:3467-3481. [PMID: 31580723 DOI: 10.2217/fon-2018-0879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim: Cervical cancer is one of the leading causes of cancer mortality in women. Peripheral white blood cell parameters such as neutrophil (NE), eosinophil (EO), basophil (BA), as well as lymphocyte (LY) and monocyte (MO), are correlated with tumor outcomes. Methods: In total, 110 cervical squamous cell carcinoma patients were recruited in this study. The potential prognostic factors were evaluated by univariate and multivariate survival analysis. Results: Cox regression analysis model indicated that higher pretreatment EO level and increased post-/preradiotherapy EO ratio were independently associated with worse progression-free survival. Lower pretreatment LY or higher EO levels and increased post-/preradiotherapy EO ratio were independently associated with worse overall survival. Conclusion: LY and EO are correlated with outcomes of cervical squamous cell cancer.
Collapse
Affiliation(s)
- Jie Zhu
- Department of Oncology, Changzhou Traditional Chinese Medical Hospital, Changzhou, Jiangsu 213003, PR China
| | - Han Wang
- Department of Oncology, Jining Cancer Hospital, Jining, Shandong 272000, PR China
| | - Min-Jie Gao
- Department of Radio-Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215001, PR China
| | - Yi-Fan Li
- Department of Oncology, Binzhou People's Hospital, Binzhou, Shandong 256600, PR China
| | - Yue-Qing Huang
- Department of General Practice, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215001, PR China
| | - Jian-Ping Shi
- Department of Radio-Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215001, PR China
| | - Wen-Jie Wang
- Department of Radio-Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215001, PR China
| |
Collapse
|
6
|
Escande A, Haie-Meder C, Maroun P, Gouy S, Mazeron R, Leroy T, Bentivegna E, Morice P, Deutsch E, Chargari C. Neutrophilia in locally advanced cervical cancer: A novel biomarker for image-guided adaptive brachytherapy? Oncotarget 2018; 7:74886-74894. [PMID: 27713124 PMCID: PMC5342709 DOI: 10.18632/oncotarget.12440] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/19/2016] [Indexed: 12/24/2022] Open
Abstract
Objective To study the prognostic value of leucocyte disorders in a prospective cohort of cervical cancer patients receiving definitive chemoradiation plus image—guided adaptive brachytherapy (IGABT). Results 113 patients were identified. All patients received a pelvic irradiation concomitant with chemotherapy, extended to the para-aortic area in 13 patients with IVB disease. Neutrophilia and leukocytosis were significant univariate prognostic factors for poorer local failure-free survival (p = 0.000 and p = 0.002, respectively), associated with tumor size, high-risk clinical target volume (HR-CTV) and anemia. No effect was shown for distant metastases but leukocytosis and neutrophila were both poor prognostic factors for in-field relapses (p = 0.003 and p < 0.001). In multivariate analysis, HR-CTV volume (p = 0.026) and neutrophils count > 7,500/μl (p = 0.018) were independent factors for poorer survival without local failure, with hazard ratio (HR) of 3.1. Materials and methods We examined patients treated in our Institution between April 2009 and July 2015 by concurrent chemoradiation (45 Gy in 25 fractions +/− lymph node boosts) followed by a magnetic resonance imaging (MRI)-guided adaptive pulse-dose rate brachytherapy (15 Gy to the intermediate-risk clinical target volume). The prognostic value of pretreatment leucocyte disorders was examined. Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophils count exceeding 10,000 and 7,500/μl, respectively. Conclusions Neutrophilia is a significant prognostic factor for local relapse in locally advanced cervical cancer treated with MRI-based IGABT. This biomarker could help identifying patients with higher risk of local relapse and requiring dose escalation.
Collapse
Affiliation(s)
- Alexandre Escande
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christine Haie-Meder
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Maroun
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France
| | - Sébastien Gouy
- Department of Surgery, Gustave Roussy, Villejuif, France
| | - Renaud Mazeron
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Thomas Leroy
- Radiotherapy Department, Oscar Lambret Comprehensive Cancer Center, Lille, France
| | | | - Philippe Morice
- Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,Department of Surgery, Gustave Roussy, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France
| | - Cyrus Chargari
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France.,French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France.,Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France
| |
Collapse
|
7
|
Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma: Meta-analysis of Extremely Rare Tumor of Cervix. Int J Gynecol Cancer 2017; 27:1957-1969. [DOI: 10.1097/igc.0000000000001086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectiveThe aim of this study was to evaluate the prognostic factors, treatment options, and survival outcomes of primary carcinosarcomas of the uterine cervix.MethodsAn electronic search of the literature was conducted from 1951 to February 2017 to identify articles on primary cervical carcinosarcoma. After comprehensive evaluation of case series and case reports, 81 cases were included in the study.ResultsThe most common clinical FIGO (International Federation of Gynecology and Obstetrics) stage was IB at 53% of cases. Median follow-up time was 15 months (range, 1.75–156 months). Two-year disease-free survival (DFS) and overall survival (OS) of the entire cohort were 49% and 60%, respectively. Both 2-year DFS and OS were significantly higher in patients with stage I than in those with stage II disease or greater (73% vs 22%, P = 0.000 and 82% vs 33%, P = 0.000, respectively). Two-year OS was 17% for patients who received primary radiotherapy, whereas it was 68% for those who underwent only surgery (P = 0.003). Surgery followed by adjuvant radiotherapy with or without chemotherapy was significantly associated with improved DFS and OS compared with primary radiotherapy. Two-year DFS was 63% in patients who underwent primary surgery, whereas it was 100% in patients treated with primary surgery followed by adjuvant radiotherapy with chemotherapy (P = 0.030). Stage alone was an independent prognostic factor for risk of both recurrence and death (hazard ratios, 9.8 [P = 0.004] and 14 [P = 0.018], respectively).ConclusionsIn due course of presentation, the tumor stage has a great importance because it is the only independent factor for prognosis. Surgery followed by adjuvant radiotherapy with or without chemotherapy seems to be related with better OS and DFS.
Collapse
|
8
|
Clark LH, Moll S, Houghton D, O'Connor S, Soper JT. Leukocytosis due to markedly elevated granulocyte-colony stimulating factor levels in a patient with endometrial cancer: Case report and literature review. Gynecol Oncol Rep 2017; 20:5-8. [PMID: 28180148 PMCID: PMC5288325 DOI: 10.1016/j.gore.2017.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/07/2017] [Accepted: 01/18/2017] [Indexed: 11/20/2022] Open
Abstract
Granulocyte-colony stimulating factor (GCSF) secretion by gynecologic tumors is rare. Elevations in serum GCSF can be seen in the absence of tumor GSCF secretion. Extreme leukocytosis is associated with autocrine tumor growth and poor prognosis.
Collapse
Affiliation(s)
- Leslie H. Clark
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of North Carolina, United States
- Corresponding author at: Gynecologic Oncology, University of North Carolina, 101 Manning Drive, CB 7572, Chapel Hill, NC 27599-7572, United States.Gynecologic OncologyUniversity of North Carolina101 Manning DriveCB 7572Chapel HillNC27599-7572United States
| | - Stephan Moll
- Department of Medicine, Division of Hematology-Oncology, University of North Carolina School of Medicine, United States
| | - Damon Houghton
- Department of Medicine, Division of Hematology-Oncology, University of North Carolina School of Medicine, United States
| | - Siohban O'Connor
- Department of Pathology, University of North Carolina School of Medicine, United States
| | - John T. Soper
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of North Carolina, United States
| |
Collapse
|
9
|
Abstract
Carcinosarcoma, also known as mixed mesodermal tumor or malignant mixed Mullerian tumor (MMMT) is a pathological entity combining a sarcomatous and a carcinomatous component. Found in thoracic, digestive, genitourinary, liver or skin locations, the most common location is the female genital tract. In gynecological tumors, carcinosarcoma accounts for about 2-5% of endometrial cancers, and 1% of ovarian cancers. To date, there is no consensus on the therapeutic strategy. It relies mostly on maximum cytoreductive surgery. Adjuvant therapy remains controversial, and few prospective studies investigating its interest. Retrospective studies show the benefits of adjuvant chemotherapy based on platinum in most cases. Radiation therapy has a place in the adjuvant situations of endometrial and cervical carcinosarcoma. A more detailed pathological knowledge, and the use of targeted therapies may be promising in this histological subtype whose prognosis remains very poor. The objective of this study is to present the main principles of carcinosarcoma management in female genital tracts, describing pathological and prognostic features at the same time.
Collapse
|
10
|
So KA, Hong JH, Jin HM, Kim JW, Song JY, Lee JK, Lee NW. The prognostic significance of preoperative leukocytosis in epithelial ovarian carcinoma: a retrospective cohort study. Gynecol Oncol 2014; 132:551-5. [PMID: 24440470 DOI: 10.1016/j.ygyno.2014.01.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/05/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Preoperative leukocytosis is known to be a negative prognostic factor for several gynecologic malignancies, but its relationship with epithelial ovarian carcinoma (EOC) is unknown. We sought to evaluate the prognostic implications of preoperative leukocytosis for women with EOC. METHODS We retrospectively reviewed the medical records of patients who underwent primary debulking surgery and adjuvant platinum-based chemotherapy for EOC between January 1993 and October 2011. Associations between leukocytosis and recurrence-free survival (RFS) and overall survival (OS) were determined by univariate analyses. Multivariate Cox proportional hazards regression was used to identify independent prognostic factors for RFS and OS. RESULTS Of 155 women, 23 (14.8%) had leukocytosis and 132 (85.2%) did not have leukocytosis. RFS and OS were significantly shorter for women with leukocytosis than for women without leukocytosis (P=0.009 and P<0.0001, respectively). The mortality rate was also higher among women with leukocytosis (P<0.0001). Multivariate analysis revealed that preoperative leukocytosis (hazard ratio [HR]: 2.15; 95% confidence interval [CI]: 1.55-4.41; P=0.009), advanced stage (HR: 3.12; 95% CI: 1.44-6.75; P=0.004), and optimal cytoreduction (HR: 0.38; 95% CI: 0.14-0.70; P=0.031) were independent prognostic factors for RFS. Additionally, preoperative leukocytosis was independently associated with decreased OS (HR: 7.66; 95% CI: 2.78-21.16; P<0.0001). CONCLUSIONS Among women with EOC, preoperative leukocytosis might be an independent prognostic factor for RFS and OS. A larger-scaled, prospective study is needed to verify these results.
Collapse
Affiliation(s)
- Kyeong A So
- Department of Obstetrics and Gynecology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jin Hwa Hong
- Department of Obstetrics and Gynecology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea.
| | - Hye Mi Jin
- Department of Obstetrics and Gynecology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jae Won Kim
- Department of Obstetrics and Gynecology, Ansan Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jae Yun Song
- Department of Obstetrics and Gynecology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jae Kwan Lee
- Department of Obstetrics and Gynecology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Nak Woo Lee
- Department of Obstetrics and Gynecology, Ansan Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| |
Collapse
|
11
|
Elevated white blood cell count at the time of recurrence diagnosis is an indicator of short survival in patients with recurrent cervical cancer. Int J Gynecol Cancer 2013; 22:1545-51. [PMID: 23051956 DOI: 10.1097/igc.0b013e31826ea0eb] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate the prognostic significance of elevated white blood cell (WBC) count at the time of the diagnosis of cervical cancer recurrence. METHODS The baseline characteristics and outcome data of 219 patients who had a diagnosis of recurrent cervical cancer between April 1996 and September 2010 were collected and reviewed. Survival after recurrence was compared between the leukocytosis group (WBC ≥9000/μL) and the nonleukocytosis group (WBC <9000/μL). A Cox proportional hazards regression model was used to investigate the prognostic significance of elevated WBC count in patients with recurrent cervical cancer. RESULTS The patients in the leukocytosis group showed significantly shorter disease-free interval (P = 0.0005) and more frequently had multiple recurrences (P = 0.0101) than those in the nonleukocytosis group. The median survival after recurrence of the patients with elevated WBC count was 9 months, which was significantly shorter than the 21 months observed in the patients without normal WBC count (log rank; P < 0.0001). Multivariate analyses revealed that clinical stage, tumor diameter, histology, an elevated WBC count (≥9000/μL), and an elevated neutrophil count (≥6500/μL) were significant prognostic factors in survival after recurrence. CONCLUSION The elevated WBC count at the time of the diagnosis of recurrence is an independent prognostic factor in patients with recurrent cervical cancer.
Collapse
|
12
|
Ohkubo Y, Kato S, Kiyohara H, Suzuki Y, Nakano T, Kamada T. Granulocyte-colony stimulating factor-producing cervical cancers treated with carbon-ion irradiation. J Obstet Gynaecol Res 2013; 39:1111-5. [PMID: 23551709 DOI: 10.1111/jog.12024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 11/08/2012] [Indexed: 11/30/2022]
Abstract
Granulocyte-colony stimulating factor (G-CSF)-producing tumor is a rare condition. It has an aggressive nature and shows resistance to conventional treatments. We report two cases of G-CSF-producing uterine cervical cancer who were successfully treated with carbon-ion radiotherapy (C-ion RT). The first case was a 76-year-old woman with stage IIIB uterine cervical cancer, and the second was a 75-year-old woman with bulky stage IIB disease. Prior to treatment, both patients presented severe granulocytosis and elevated serum G-CSF concentrations. After C-ion RT, their cervical tumors completely disappeared, and their granulocytosis and elevated serum G-CSF levels improved as well. C-ion RT has been reported to be effective for various aggressive tumors, and it may be a good treatment option for this rare aggressive tumor.
Collapse
Affiliation(s)
- Yu Ohkubo
- Department of Radiology, Saitama Cancer Center, Ina, Kita-adachi, Saitama, Japan.
| | | | | | | | | | | |
Collapse
|
13
|
Yamamoto K, Mabuchi S, Yamasaki M, Yoshimura M, Murata Y. Grave outcome of granulocyte colony-stimulating factor-producing endometrial cancer: A case report and literature review. J Obstet Gynaecol Res 2012; 39:1107-10. [DOI: 10.1111/j.1447-0756.2012.02060.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/18/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Kasumi Yamamoto
- Department of Obstetrics and Gynecology; Belland General Hospital; Sakai; Osaka; Japan
| | - Seiji Mabuchi
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Suita; Osaka; Japan
| | - Masato Yamasaki
- Department of Obstetrics and Gynecology; Belland General Hospital; Sakai; Osaka; Japan
| | - Michiko Yoshimura
- Department of Pathology; Belland General Hospital; Sakai; Osaka; Japan
| | - Yuji Murata
- Department of Obstetrics and Gynecology; Belland General Hospital; Sakai; Osaka; Japan
| |
Collapse
|
14
|
Mabuchi S, Matsumoto Y, Isohashi F, Yoshioka Y, Ohashi H, Morii E, Hamasaki T, Aozasa K, Mutch DG, Kimura T. Pretreatment leukocytosis is an indicator of poor prognosis in patients with cervical cancer. Gynecol Oncol 2011; 122:25-32. [DOI: 10.1016/j.ygyno.2011.03.037] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 03/28/2011] [Accepted: 03/31/2011] [Indexed: 11/26/2022]
|
15
|
The first 2 cases of granulocyte colony-stimulating factor producing adenocarcinoma of the uterine cervix. Int J Gynecol Pathol 2010; 29:483-7. [PMID: 20736776 DOI: 10.1097/pgp.0b013e3181d29729] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing nonhematopoietic malignancies have been reported in various organs, and most of them have been associated with poor clinical outcome. However, because of the rarity of the reported cases, information regarding the G-CSF-producing gynecological malignancies is limited. We report the first 2 cases of G-CSF-producing cervical adenocarcinomas, which exhibited an aggressive clinical course. At initial diagnosis, both patients exhibited marked leukocytosis without an obvious sign of infections. Of these, one was initially treated with definitive radiotherapy and the other was treated with radical surgery. However, both of these patients experienced recurrences in a short period and died from disease progression in less than 6 months. According to the facts that the tumor cells were positive for G-CSF, the elevated serum level of G-CSF, and their clinical course correlated well with the white blood cell count, we concluded that these tumors were G-CSF-producing cancers. These cases strongly indicate the aggressive nature of the G-CSF-producing cervical adenocarcinomas.
Collapse
|
16
|
López-Olmos J, Navarro P, Montoliu G, López-Puchau E. Carcinosarcoma de cérvix asociado a teratoma quístico maduro de ovario. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2010. [DOI: 10.1016/j.gine.2009.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Matsumoto Y, Mabuchi S, Muraji M, Morii E, Kimura T. Squamous cell carcinoma of the uterine cervix producing granulocyte colony-stimulating factor: a report of 4 cases and a review of the literature. Int J Gynecol Cancer 2010; 20:417-21. [PMID: 20375807 DOI: 10.1111/igc.0b013e3181d15a11] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing malignant tumor has been reported to occur in various organs, and most of which has been associated with poor clinical outcome. However, because of the rarity of the reported cases, information regarding the G-CSF-producing gynecological malignancies is limited. We report 4 cases of G-CSF-producing cervical cancers. At initial diagnosis, all of the 4 patients exhibited marked leukocytosis without an obvious sign of infection. Of the 4 patients, 3 had their disease initially treated with definitive radiotherapy, and one was treated with radical surgery. Despite the aggressive treatments, all of these patients experienced recurrences within 6 months. In all cases, the white blood cell count returned to the normal range in response to the initial treatment and then increased again with recurrences. Based on the facts that the tumor cells were positive for G-CSF, the serum level of G-CSF was elevated, and their clinical course correlated well with the white blood cell count, we concluded that these tumors were G-CSF-producing cancers. All patients died from disease progression in less than 15 months. These cases strongly indicate the aggressive nature of the G-CSF-producing cervical cancer.
Collapse
Affiliation(s)
- Yuri Matsumoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine. 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | | | | | | | | |
Collapse
|
18
|
Laterza R, Seveso A, Zefiro F, Formenti G, Mellana L, Donadello N, Ghezzi F, Bolis P, Riva C. Carcinosarcoma of the uterine cervix: Case report and discussion. Gynecol Oncol 2007; 107:S98-100. [PMID: 17727926 DOI: 10.1016/j.ygyno.2007.07.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 07/06/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cervical carcinosarcomas are rare neoplasms; optimal treatment is unclear. CASE 1: A 42-year-old woman underwent abdominal hysterectomy because of bleeding, anaemia and uterine fibromatosis. Histology showed a homologous carcinosarcoma of the cervix. Laparoscopic re-staging (pelvic lymphadenectomy, bilateral salpingo-oophorectomy) was negative for neoplasia. Adjuvant chemotherapy with ifosfamide and cisplatin was performed. At 48 months of follow-up, the patient is NED. CASE 2: A 74-year-old woman reporting vaginal bleeding, with carcinosarcoma on the cervical biopsy, underwent radical hysterectomy, bilateral salpingo-oophorectomy, pelvic and paraortic lymphadenectomy. Histology confirmed a homologous carcinosarcoma of the cervix, stage IIb. Whole-pelvis irradiation and brachytherapy were carried out. Nine months later, the patient developed systemic recurrence and died of disease. Aggressive primary therapy can result in cure of early-stage cervical carcinosarcomas. Extracervical disease is associated with a poor prognosis.
Collapse
Affiliation(s)
- Rosa Laterza
- Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Garcia-Arias A, Cetina L, Candelaria M, Robles E, Dueñas-González A. The prognostic significance of leukocytosis in cervical cancer. Int J Gynecol Cancer 2007; 17:465-70. [PMID: 17309562 DOI: 10.1111/j.1525-1438.2007.00816.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Cervical cancer is a frequent tumor with established prognostic factors such as FIGO stage and hemoglobin levels among others. Despite the fact that paraneoplastic leukocytosis is relatively common in many solid tumors, only isolated cases of cervical cancer patients presenting this abnormality have been published; hence, the clinical significance of leukocytosis is unknown in this tumor type. Retrospective review on the medical records of 294 consecutive newly diagnosed and untreated locally advanced cervical cancer patients who received radiotherapy and concurrent cisplatin was conducted. Leukocytosis was defined as a persistent white blood cell count exceeding 10,800/microL, determined at least twice before commencing chemoradiation providing that patients were free of any active acute or chronic infection or any other condition known to elevate the leukocyte count. The frequency of leukocytosis and their correlation with clinicopathologic features were investigated, as well as their impact on tumor response and survival. Leukocytosis with a median value of 13,300/microL (11,100-28,800) was observed in 35 (11.9%) patients at diagnosis. Leukocytosis was statistically associated only with advanced stages. Clinical complete response was observed in 57% versus 86% of the patients with and without leukocytosis, respectively. In the univariate analysis, leukocytosis, stage, and hemoglobin levels were significant predictors of survival; however, only leukocytosis and the hemoglobin level remained significant predictors of survival in the multivariate analysis. Leukocytosis is common in cervical cancer patients and has a negative prognostic significance.
Collapse
Affiliation(s)
- A Garcia-Arias
- Division of Clinical Research, Instituto Nacional de Cancerología de México, UNAM, México
| | | | | | | | | |
Collapse
|
20
|
Abstract
When connective tissue undergoes malignant transformation, glioblastomas and sarcomas arise. However, the ancient biochemical mechanisms, which are now operational in sarcomas distorted by mutations and gene fusions in misaligned chromosomes, were originally acquired by those cells that emerged during the Cambrian explosion. Preserved throughout evolution up to the genus Homo, these mechanisms dictate the apoptosis- and senescence-resistant immortality of malignant cells. A 'retroviral paradox' distinguishes human sarcomas from those of the animal world. In contrast to the retrovirally induced sarcomatous transformation of animal (avian, murine, feline and simian) cells, human sarcomas have so far failed to yield a causative retroviral isolate. However, the proto-oncogenes/oncogenes transduced from their host cells by retroviruses of animals are the same that are active in human sarcomas. Since the encoded oncoproteins arise after birth, they are recognized frequently by the immune system of the host. Immune lymphocytes that kill autologous sarcoma cells in vitro commonly fail to do so in vivo. Sarcoma vaccines generate immune T- and natural killer cell reactions; even when vaccinated patients do not show a clinical response, their tumors become more sensitive to chemotherapy. The aim of this review is to lay a solid molecular biological foundation for the conclusion that targeting the sarcoma oncogenes will result in regression of the disease.
Collapse
Affiliation(s)
- Joseph G Sinkovics
- Cancer Institute of St. Joseph's Hospital Affiliated with the HL Moffitt Cancer Center, The University of South Florida College of Medicine, Department of Medical Microbiology and Immunology, Tampa, Florida, USA.
| |
Collapse
|