Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemorad...Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemoradiotherapy （CCRT）. Methods： Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively： These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period （between 2,006 and Z011） and selected randomly. Results： Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag 〉 10 ng/mL in the group with persistent or recurrent disease before treatment （P〈0.01）. Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉 10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion： Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within i year after CCRT.展开更多
Background: The main objective of this study is to analyse the change in the type of lesions developed by HPV-infected patients after the introduction of the vaccine in three different periods;2002-2006 (years previou...Background: The main objective of this study is to analyse the change in the type of lesions developed by HPV-infected patients after the introduction of the vaccine in three different periods;2002-2006 (years previous to the implementation of the vaccine in Spain), 2009-2011 (shortly after the vaccination) and 2020-2021 (years where the vaccine was well established) at a single hospital. Methods: This is an observational, descriptive, retrospective study based on the review of the results of the biopsies of patients with HPV lesions at a single large tertiary hospital, Hospital Clínico San Carlos, in Madrid, Spain. We have collected the data from three different time periods: 2002-2006, 2009-2011, 2020-2021 to try to understand the potential changes in these lesions after vaccine introduction. Results: In this time we have reviewed the data from 946 women. In these three periods, a decreasing trend in the rate of squamous cell carcinoma was noted, the rate of adenocarcinoma remains stable, and the rate of cervical intraepithelial neoplasia grades 2 - 3 (CIN 2-3) lesions shows an increasing trend. We have also found a change in the mean ages of the patients with these lesions, as this increased in the three lesions caused by HPV after the implementation of the vaccine. Our study indicates that the identification of other high risk serotypes, apart from 16 and 18, as well as those with indeterminate risk, has undergone a progressive increase, increasing from 24.24% and 14.11% respectively in 2002-2006 to 40.42% and 28.34% in 2020-2021. Conclusion: Our study confirms the effectiveness of the vaccines developed so far, against the HPV serotypes they contain. This is demonstrated by the evidence, in our population, of a decrease in the incidence of squamous cell carcinoma in uterine cervix. In parallel, an increase in the mean age of diagnosis has been verified, for both squamous cell carcinoma and its CIN 2-3 precursor lesions, as well as a change in the infective trend of HPV serotypes that are not included in the current vaccines.展开更多
文摘Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemoradiotherapy （CCRT）. Methods： Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively： These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period （between 2,006 and Z011） and selected randomly. Results： Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag 〉 10 ng/mL in the group with persistent or recurrent disease before treatment （P〈0.01）. Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉 10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion： Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within i year after CCRT.
文摘Background: The main objective of this study is to analyse the change in the type of lesions developed by HPV-infected patients after the introduction of the vaccine in three different periods;2002-2006 (years previous to the implementation of the vaccine in Spain), 2009-2011 (shortly after the vaccination) and 2020-2021 (years where the vaccine was well established) at a single hospital. Methods: This is an observational, descriptive, retrospective study based on the review of the results of the biopsies of patients with HPV lesions at a single large tertiary hospital, Hospital Clínico San Carlos, in Madrid, Spain. We have collected the data from three different time periods: 2002-2006, 2009-2011, 2020-2021 to try to understand the potential changes in these lesions after vaccine introduction. Results: In this time we have reviewed the data from 946 women. In these three periods, a decreasing trend in the rate of squamous cell carcinoma was noted, the rate of adenocarcinoma remains stable, and the rate of cervical intraepithelial neoplasia grades 2 - 3 (CIN 2-3) lesions shows an increasing trend. We have also found a change in the mean ages of the patients with these lesions, as this increased in the three lesions caused by HPV after the implementation of the vaccine. Our study indicates that the identification of other high risk serotypes, apart from 16 and 18, as well as those with indeterminate risk, has undergone a progressive increase, increasing from 24.24% and 14.11% respectively in 2002-2006 to 40.42% and 28.34% in 2020-2021. Conclusion: Our study confirms the effectiveness of the vaccines developed so far, against the HPV serotypes they contain. This is demonstrated by the evidence, in our population, of a decrease in the incidence of squamous cell carcinoma in uterine cervix. In parallel, an increase in the mean age of diagnosis has been verified, for both squamous cell carcinoma and its CIN 2-3 precursor lesions, as well as a change in the infective trend of HPV serotypes that are not included in the current vaccines.
