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...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 2006 and 2011)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 1 year after CCRT.展开更多
Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer.Methods:The relevant literature has served as a source for identified high or intermediate risks and management of s...Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer.Methods:The relevant literature has served as a source for identified high or intermediate risks and management of stage ⅠB cervical cancer.Result:The high risks include pelvic lymph node metastasis(PLNM),positive resection margin(PRM),and the involvement of parametrium(IPM).The intermediate risks include deep stromal invasion(DSI),bulky tumor size(BTS),lymphovascular space invasion(LVSI).Adeno-carcinomatous histotype is the new risk feature relevant to poor prognoses.Both radical hysterectomy plus bilateral pelvic lymph node dissection(PLND) and radical radiotherapy have proven to be equally effective.Surgery is more performed for stage ⅠB1 disease;radiotherapy or chemoradiotherapy is preferable for stage ⅠB2 disease.For patients with one high risk or two of intermediate risks,radical hysterectomy plus PLND followed by concurrent chemoradiotherapy can improve overall survival(OS) and disease-free survival(DFS).Conclusion:The management should be individualized for stage ⅠB cervical cancer.The optimized multidisciplinary therapy can benefit patients with the best cure and minimum morbidity and complications.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 2006 and 2011)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 1 year after CCRT.
文摘Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer.Methods:The relevant literature has served as a source for identified high or intermediate risks and management of stage ⅠB cervical cancer.Result:The high risks include pelvic lymph node metastasis(PLNM),positive resection margin(PRM),and the involvement of parametrium(IPM).The intermediate risks include deep stromal invasion(DSI),bulky tumor size(BTS),lymphovascular space invasion(LVSI).Adeno-carcinomatous histotype is the new risk feature relevant to poor prognoses.Both radical hysterectomy plus bilateral pelvic lymph node dissection(PLND) and radical radiotherapy have proven to be equally effective.Surgery is more performed for stage ⅠB1 disease;radiotherapy or chemoradiotherapy is preferable for stage ⅠB2 disease.For patients with one high risk or two of intermediate risks,radical hysterectomy plus PLND followed by concurrent chemoradiotherapy can improve overall survival(OS) and disease-free survival(DFS).Conclusion:The management should be individualized for stage ⅠB cervical cancer.The optimized multidisciplinary therapy can benefit patients with the best cure and minimum morbidity and complications.
