UI - 11905696
AU - Sharma DC
Indian centre develops teletherapy machine for cervical cancer.
SO - Lancet Oncol 2000 Sep;1(1):9
UI - 11972390
AU - Chen GD; Lin LY; Wang PH; Lee HS
Urinary tract dysfunction after radical hysterectomy for cervical
SO - Gynecol Oncol 2002 May;85(2):292-7
AD - Department of Obstetrics and Gynecology, Chung Shan Medical University
Hospital, 110, section 2, Chien-Kao N. Road, Taichung 40201, Taiwan.
OBJECTIVES: To evaluate the urinary tract dysfunction following a
radical hysterectomy and to compare the baseline urodynamical parameters
of women who had uterine cervical carcinoma with women who had CIN 3.
METHODS: A prospective case-control study was conducted to evaluate
preoperative and postoperative urinary tract function of thirty-two
cervical carcinoma patients using twenty-seven CIN 3 patients'
preoperative urodynamical parameters as a baseline control. RESULTS: The
rate of detrusor instability in women with preoperative cervical
carcinoma was higher than that of women with CIN 3 (37.5 % vs. 14.8 %, P
< 0.05). In the cervical carcinoma patients, there were 53.1 % who had
normal urinary tract function, but after a radical hysterectomy they
began voiding by abdominal straining. The impairment of bladder
sensation, alteration of bladder capacity and bladder compliance,
compromise of detrusor function, reduction of maximal urethral pressure
and maximal urethral closure pressure, and the decrease of the pressure
transmission ratio were significantly noted after a radical
hysterectomy. The rate of genuine stress incontinence did not increase
significantly (9.4 % vs. 18.8%, P > 0.05), but the rate of detrusor
instability decreased significantly (37.5% vs. 15.6%, P < 0.05) after a
radical hysterectomy. CONCLUSIONS: Changes of urinary tract function
after a radical hysterectomy might be related to the partial sympathetic
and parasympathetic denervation during a radical dissection. More than
half of the women who preoperatively had normal urinary tract function
needed to void by abdominal straining after radical surgery. (c) 2002
Elsevier Science (USA).
UI - 11972396
AU - Kasamatsu T; Okada S; Tsuda H; Shiromizu K; Yamada T; Tsunematsu R; Ohmi
Early invasive adenocarcinoma of the uterine cervix: criteria for
nonradical surgical treatment.
SO - Gynecol Oncol 2002 May;85(2):327-32
AD - Division of Gynecology, National Cancer Center Hospital, 5-1-1 Tsujkiji,
Chuo-ku, Tokyo 104-0045, Japan. firstname.lastname@example.org
OBJECTIVE: This retrospective study was undertaken to identify selection
criteria for nonradical surgery for early invasive adenocarcinoma of the
uterine cervix. METHODS: Seventy-nine patients with surgically treated
cervical adenocarcinomas (with invasion to 5 mm or less) were examined
clinicopathologically. The evaluation of stromal invasion was conducted
according to the FIGO (1995) staging system. RESULTS: The mean age was
46 (range: 29-73) years, and the median follow-up was 118 (9-348)
months. Definitive treatment modalities included radical hysterectomy in
71 (89.9%) cases, modified radical hysterectomy in 2 (2.5%), and simple
extrafascial hysterectomy without pelvic lymphadenectomy in 6 (7.6%).
Postoperative adjuvant external radiation therapy was given to 5 (6.3%)
patients. The histological subtypes were endocervical in 37 (46.8%)
cases, endometrioid in 32 (40.5%), and adenosquamous in 10 (12.7%).
Forty-one (51.9%) patients had lesions with up to 3 mm of stromal
invasion; of these, 24 (58.5%) had lesions with up to 7 mm of horizontal
extension (stage IA1). Thirty-eight (48.1%) patients had lesions with
stromal invasion greater than 3 mm and no greater than 5 mm; of these, 4
had lesions with no wider than 7 mm of horizontal extension (stage IA2).
Of 73 patients with pelvic lymphadenectomy, one (1.4%) tumor (depth: 5
mm; width: 15 mm) had node metastases. Parametrial involvement was
present in one (1.4%) patient (lesion depth: 5 mm; lesion width: 16 mm).
None had adnexal metastasis. Eighty-eight percent of the patients with
stromal invasion up to 3 mm had well-differentiated adenocarcinoma,
compared to 53% of the patients with lesions invading more than 3 mm. Of
all of the patients, 5 (6.3%) patients who received curative radical
hysterectomies had recurrences and died. Among 5 patients, one patient
with central pelvic recurrence had a lesion invading to a depth of 3 mm
and width of 7 mm, and the others had lesions with more than 3 mm of
invasion and 15 to 36 mm of width. CONCLUSIONS: Patients with early
invasive adenocarcinoma to a depth of 3 mm or less stromal invasion,
including those who meet the criteria for FIGO stage IA1, may be treated
with simple extrafascial hysterectomy without lymphadenectomy and
oophorectomy. (c) 2002 Elsevier Science (USA).
UI - 12035486
AU - Bernard A; Touboul E; Lefranc JP; Deniaud-Alexandre E; Genestie C; Uzan
S; Blondon J
[Epidermoid carcinoma of the uterine cervix at operable bulky stages IB
and II treated with combined primary radiation therapy and surgery]
SO - Cancer Radiother 2002 Apr;6(2):85-98
AD - Hopital Tenon AP-HP, 4, rue de la Chine, 75020 Paris, France.
PURPOSE: To identify prognostic factors and treatment toxicity in a
series of operable bulky stages I and II cervical carcinomas treated
with a therapeutic modality combining primary irradiation and surgery.
bulky squamous-cell cervical carcinomas (stage IB2, IIA, and IIB with
1/3 proximal parametrial invasion) underwent primary external beam
pelvic radiation therapy (37.40 Gy to 40 Gy over 4.5 weeks) and
low-dose-rate uterovaginal brachytherapy (20 Gy) followed, 5 to 6 weeks
later, by class II modified radical hysterectomy with bilateral pelvic
lymphadenectomy. The four last patients received concomitant
chemotherapy during the first and the fourth radiation week combining
5-FU and cisplatin. A clinical pelvic lymph node involvement had been
observed in 7 patients. The clinical median tumor size was 5 cm in
diameter (range: 4.5-8 cm). The median follow-up was 97 months. RESULTS:
Pathologic complete tumor response in specimen of hysterectomy were
observed in 46 patients. Six patients had pathologic unilateral iliac
lymph node involvement. The 5- and 10-year specific survival rates were
79 and 74%, respectively. The 5- and 10-year disease-free survival rates
were 76% and 71%, respectively. The 10-year local control rate was 85%.
The 10-year probability for pelvic recurrence was significantly
influenced by the pathologic tumor response: 26% in the residual group
vs 5% in the complete tumor response group, P = 0.024). After
multivariate analysis, the independent factors decreasing the
probability of disease-free survival were: pathologic pelvic lymph node
involvement (P = 0.029), and parametrial invasion (P = 0.031). Five late
severe complications requiring surgical intervention were observed: 2
bowel obstructions, 1 ureteral stenosis, 1 vesicovaginal fistula, and 1
radiation induced unilateral femoral necrosis. CONCLUSION: A good local
control is obtained after combined primary radiation therapy and surgery
for bulky stages I and II cervical carcinomas. In our more recent
practice, the treatment combines primary concomitant chemoradiation
followed by surgery including pelvic and para-aortic lymphadenectomy.
UI - 11774604
AU - Adams M; Borysiewicz L; Fiander A; Man S; Jasani B; Navabi H; Evans AS;
Clinical studies of human papilloma vaccines in cervical cancer.
SO - Adv Exp Med Biol 2001;495():419-27
AD - University of Wales College of Medicine.
UI - 12001758
AU - Panek G; Zielinski J; Bidzinski M
[Results of treating stage IB invasive carcinoma of the cervix
SO - Ginekol Pol 2002 Jan;73(1):24-9
AD - Kliniki Nowotworow Narzadow Plciowych Kobiecych Centrum
The results of radical surgery in 18 patients with stage IB invasive
carcinoma of the cervix with concurrent pregnancy are presented. All
patients were treated with radical Wertheim-Meigs hysterectomy with
ovarian preservation. In four cases the treatment was delayed to meet
patients will and achieve fetal maturity. There was no significant
difference in the expected five-year survival of analyzed population (5
yrs survival of 83%) and control group consisting of 32 patients with
stage IB carcinoma of the cervix without accompanying pregnancy treated
in the same method and the same time. All patients with planned delay in
therapy were cured.
UI - 12001760
AU - Bidzinski M; Zielinski J; Panek G
[Stage IIb invasive carcinoma of the cervix during pregnancy--personal
experience and contemporary opinions on this topic]
SO - Ginekol Pol 2002 Jan;73(1):30-4
AD - Kliniki Nowotworow Narzadow Plciowych Kobiecych Centrum Onkologii,
Five cases of the cervical cancer in stage II b coexisting with
pregnancy were presented. All patients were treated by radical
radiotherapy consisting of external beam irradiation and brachytherapy.
The spontaneous abortion or premature labor occurred during radiation
after the dose 30.6-32 Gy of irradiation was delivered. In two cases
where cervical carcinoma was diagnosed during the III trimester,
cesarean section were performed between 34 and 36 weeks of gestation.
Two healthy babies were delivered. Only in one case the recurrence
occurred and that woman died 43 months after the initial diagnosis.
Individualization of the treatment in such cases should be considered.
It is necessary to establish centers which could be experienced in the
treatment of pregnant women suffering from cervical cancer.
UI - 12052589
AU - Paraskevaidis E; Davidson EJ; Koliopoulos G; Alamanos Y; Lolis E;
Bleeding after loop electrosurgical excision procedure performed in
either the follicular or luteal phase of the menstrual cycle: a
SO - Obstet Gynecol 2002 Jun;99(6):997-1000
AD - Department of Obstetrics and Gynecology, Ioannina University Hospital,
Ioannina, Greece. email@example.com
OBJECTIVE: To estimate the perioperative or postoperative bleeding rates
after treatment of cervical intraepithelial neoplasia by loop
electrosurgical excision procedure in either the follicular or luteal
phase of the menstrual cycle. METHODS: A randomized controlled trial was
carried out to compare the outcomes in terms of primary and secondary
hemorrhage between patients treated by loop electrosurgical excision
procedure during either the follicular (30 women) or luteal phase (30
women) of the menstrual cycle. The two groups did not differ in terms of
mean age, grade of cervical intraepithelial neoplasia, depth of
excision, parity, and duration of menses. Primary outcome measures
included the objective and subjective assessment of intraoperative and
postoperative bleeding. RESULTS: Women treated during the luteal phase
of the menstrual cycle experienced significantly more postoperative
bleeding than women treated during the follicular phase, as assessed by
the fall in hematocrit levels (P <.001) and subjective reports.
Intraoperative bleeding was judged to be more severe in women treated
during the luteal phase of the cycle by a single, blinded colposcopist
(P =.02). These women also experienced higher levels of anxiety
postoperatively, which resulted in more consultations with medical staff
(P =.007). CONCLUSION: The use of loop electrosurgical excision
procedure to treat cervical intraepithelial neoplasia results in less
bleeding if performed during the follicular phase of the menstrual
UI - 11975675
AU - Beskow C; Agren-Cronqvist AK; Granath F; Frankendal B; Lewensohn R
Pathologic complete remission after preoperative intracavitary
radiotherapy of cervical cancer stage Ib and IIa is a strong prognostic
factor for long-term survival: analysis of the Radiumhemmet data
SO - Int J Gynecol Cancer 2002 Mar-Apr;12(2):158-70
AD - Department of Gynecologic Oncology, Radiumhemmet, Karolinska Hospital,
S-171-76 Stockholm, Sweden.
The purpose of this study was to evaluate the treatment results of
preoperative brachytherapy and the prognostic value of pathologic
complete remission after preoperative intracavitary irradiation in
patients with stage Ib and IIa cervical carcinoma in relation to
recurrence rate and survival. The clinical records of 185 patients with
stage Ib (129 patients) and IIa (56 patients) cervical carcinoma,
1991 were reviewed. The median follow-up time was 71 months. In 121
patients the treatment consisted of uterovaginal intracavitary
irradiation, according to the Stockholm technique, followed by surgery.
Tumor remission assessed in the surgical specimen was classified as
pathologic complete remission (pCR) if no microscopic tumor was found or
incomplete pathologic remission (non-pCR) if microscopic residual tumor
was found. Postoperative external beam radiation was added to cases with
metastases in pelvic nodes or residual tumor in the resection margins.
The disease-specific 5-year survival was 87% and 75% for stage Ib and
IIa, respectively, for the patient population treated with preoperative
intracavitary radiotherapy and surgery. After intracavitary radiation,
79% of the patients obtained pCR of the primary tumor. Five-year
survival in those with pCR was 95%, compared with 46% in those with
non-pCR (P < 0.0001). Patients with pCR and no lymph node metastases had
a 98% 5-year survival as compared to a 5-year survival of 64% in
patients with non-pCR and node negativity (P < 0.0001). Locoregional
relapses were diagnosed in 2% of the patients with pCR compared to 54%
in patients with non-pCR (P < 0.0001). Multivariate analysis revealed
non-pCR (RR = 6.42) and node positivity (RR = 4.59) as nonfavorable
factors for survival, while tumor size was not found to be of
independent significance for survival. Pathologic complete remission
after intracavitary irradiation is a strong favorable prognostic factor
in node-negative patients. The combination of preoperative intracavitary
radiotherapy and surgery results in a high cure rate and aids in
identifying patients at risk for relapse who might be subject to
UI - 11975678
AU - Uno T; Ito H; Itami J; Sato T; Minoura S; Yasuda S; Aruga T; Isobe K;
Shigematsu N; Kubo A
Adjuvant pelvic irradiation in patients with pathologic T2b carcinoma of
the uterine cervix.
SO - Int J Gynecol Cancer 2002 Mar-Apr;12(2):187-91
AD - Department of Radiation Oncology, School of Medicine, Chiba University,
Inohana 1-8-1, Chuou-ku, Chiba City, Chiba 260-8670, Japan.
Patients with cervical cancer are subject to postoperative adjuvant
therapy if the histopathologic examination reveals parametrial
involvement. This study evaluated the patterns of failure in patients
with pathologic parametrial invasion (pT2b) treated with adjuvant pelvic
cervical cancer were treated with postoperative pelvic irradiation. The
median age was 52 years. Preoperative clinical stages were stage Ib in 8
patients, IIa in 4, and IIb in 33. Twenty-three patients had lymph node
metastasis. The median total dose of whole pelvic radiation therapy was
50 Gy. Occurrence of pelvic failure or distant metastasis according to
the nodal status was examined. None of the 22 patients without lymph
node metastasis developed distant metastasis. Among the 23 node-positive
patients, 6 developed distant metastasis as an initial failure site. The
5-year overall survival of the entire group was 78%. The actuarial
distant metastasis-free rates at 5 years were 73% and 100% for those
with and without pelvic lymph node metastasis, respectively (P = 0.016).
Results support previous evidence for chemoradiation in patients with
pelvic lymph node metastasis. However, it appears that the role of
systemic chemotherapy for node-negative pT2b patients is yet to be
UI - 11975688
AU - Narayan K
Type III radical hysterectomy induction chemotherapy for patients with
locally advanced cervical carcinoma.
SO - Int J Gynecol Cancer 2002 Mar-Apr;12(2):232; discussion 232-3
UI - 11692540
AU - Caputo S; Salvi M; Ciardo A
[Prognosis and treatment of cervix uteri carcinoma in pregnancy]
SO - Clin Ter 2001 May-Jun;152(3):197-200
AD - Istituto di I Clinica Ostetrica e Ginecologica, Policlinico Umberto I di
Roma, Universita La Sapienza, Roma, Italia.
Carcinoma of the cervix is tha most common ginecologic cancer found
during pregnancy. Management and treatment of this condition depend on
cancer stage and estimated gestational age. Pregnancy represents an
ideal time for cervical cancer screening, and all pregnant women
presenting for prenatal care should be carefully examinated. The
prognosis for pregnant women is similar to that for non-pregnant one.
The aim of this study is to review the incidence, treatment and
prognosis of this condition during pregnancy.
UI - 12051763
AU - Lopez-Marure R; Gutierrez G; Mendoza C; Ventura JL; Sanchez L; Reyes
Maldonado E; Zentella A; Montano LF
Ceramide promotes the death of human cervical tumor cells in the absence
of biochemical and morphological markers of apoptosis.
SO - Biochem Biophys Res Commun 2002 May 10;293(3):1028-36
AD - Departamento de Biologia Celular, Instituto Nacional de Cardiologia
Ignacio Chavez, Juan Badiano No. 1, Colonia Seccion 16, Tlalpan, C.P.
14080, Mexico DF, Mexico. firstname.lastname@example.org
C8-ceramide, a synthetic cell-permeable analog of endogenous ceramides,
interfered with cell proliferation, and was cytotoxic to papilloma
virus-containing human cervix carcinoma cells, CALO, INBL, and HeLa,
that match two clinical stages of tumor progression. C8-ceramide (3
microM) markedly reduced the tumor cell number after 48 h of treatment,
an effect that endured even after the removal of C8-ceramide. The
carcinoma cells showed morphologic changes, characteristic of necrosis
and released lactate dehydrogenase (LDH). A biologically inactive analog
C8-dihydro-ceramide had no effect on cell viability in any of the cell
lines tested. Seventy-two hours after C8-ceramide treatment none of the
biochemical and morphological markers characteristic of apoptosis: (a)
nuclear chromatin condensation, (b) DNA fragmentation, (c) proteolysis
of the caspase-3 substrate poly-(ADP-ribose)-polymerase (PARP), and (d)
appearance of phosphatidylserine on the external cell membrane, were
observed. C8-ceramide had no effect on human cervix fibroblasts and
induced a mild reduction (30%) in the proliferation of normal human
cervix epithelia and HeLa cells (IV-B metastatic stage). The
cytotoxicity of C8-ceramide was restricted to CALO (early II-B) and INBL
(IV-A non-metastatic) carcinoma cells. The possible application of
ceramide in the treatment of early stages of cervical cancer is
discussed. (c) 2002 Elsevier Science (USA).
UI - 12040296
AU - Abdel-Wahab M; Wolfson A; Ossi P; Raub W; Markoe A
University of Miami experience using one versus two intracavitary
SO - Am J Clin Oncol 2002 Jun;25(3):313-7
AD - University of Miami School/Jackson Memorial Hospital, Florida, USA.
This retrospective study was done to determine whether the number of
brachytherapy implants significantly influenced outcome in 86 patients
with carcinoma of the cervix treated with radiation alone at the
1995. One brachytherapy application was performed in 36 (42%) of the
study cohort, whereas 50 (58%) had two implants. Cumulative doses to
points A and B ranged from 60.74 Gy to 97.58 Gy (median: 82.46 Gy) and
46.57 Gy to 73.99 Gy (median: 58.51 Gy), respectively. Five-year overall
survival (OS) and disease-free survival (DFS) for study patients were
49.4% and 38.7%, respectively. Patients receiving two implants had a
higher total dose to point A (p = 0.02), were less likely to complete
the radiation in less than 8 weeks (p = 0.01), and showed a trend of
having more advanced disease (p = 0.1) and a greater rate of chronic
complications (p = 0.09). Univariate analysis failed to demonstrate a
statistically significant difference in either OS or DFS concerning one
versus two brachytherapy procedures in this series. However, because of
the confounding interactions of cumulative dose to point A and overall
treatment time in the present series, a prospectively randomized phase
III trial is needed to more adequately evaluate this question.
UI - 12057073
AU - Leitao MM Jr; Chi DS
Recurrent cervical cancer.
SO - Curr Treat Options Oncol 2002 Apr;3(2):105-11
AD - Memorial Sloan-Kettering Cancer Center, Gynecology Service, Department
of Surgery, c/o Gynecology Service Academic Office, 1275 York Avenue,
Room MRI-1027, New York, NY 10021, USA. email@example.com
There are limited treatment options for patients with recurrent cervical
carcinoma. Because of low response rates and a negligible impact on
long-term survival, the use of chemotherapy in patients with
unresectable recurrent disease should be considered palliative.
Generally, radiation therapy in previously irradiated patients is
considered palliative. For patients who develop recurrent disease after
definitive surgery who have not received prior radiation therapy,
salvage radiation therapy is the treatment of choice. Similarly,
patients who have received definitive primary radiation therapy are
candidates for surgical resection of their recurrence. However, there
are specific criteria for surgical resection. Radical hysterectomy may
be an option for the very rare patient with a small (<2 cm) centrally
located recurrence in the cervix or vaginal fornices. However, for most
patients, pelvic exenteration remains the only therapeutic option that
offers the possibility of long-term survival. Patients who are
candidates for exenteration are those with central local recurrences
that have not extended to the pelvic sidewalls. The introduction of
high-dose-rate intraoperative radiation therapy (HDR-IORT) combined with
radical surgical resection has widened the scope of patients who may be
offered surgery. Patients who in the past may not have been surgical
candidates may benefit from radical surgical resection combined with
HDR-IORT. All patients who are surgically fit and have undergone
previous radiation therapy should be considered for surgical resection
for centrally located recurrences. Patients whose recurrences extend
close to the pelvic sidewalls should be referred to centers where
HDR-IORT is available.
UI - 12043223
AU - Toita T
[Uterine cervical cancer]
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2002 Apr;62(5):198-201
AD - Department of Radiology, University of the Ryukyus School of Medicine.
Most practice standards have been determined empirically in radiotherapy
for uterine cervical cancer. On the other hand, a large volume of
clinical data on cervical cancer has been published. A practice of
evidence-based medicine (EBM) can offer the most suitable management for
individual patients with cervical cancer.
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