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1. Fabrini MG, Gadducci A, Perrone F, Cosio S, Laliscia C, Pasqualetti F, Grespi S, Cionini L: Clinical outcome of tailored adjuvant postoperative chemoradiotherapy in IB FIGO stage cervical cancer. Anticancer Res; 2009 Oct;29(10):4205-10
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical outcome of tailored adjuvant postoperative chemoradiotherapy in IB FIGO stage cervical cancer.
  • AIM: The aim of the present report is to review a mono-institutional experience of postoperative radiotherapy in selected patients with cervical cancer.
  • PATIENTS AND METHODS: Between 1999 and 2008, fifty-one patients with high-risk stage IB cervical cancer underwent tailored adjuvant postoperative radiotherapy; concurrent chemoradiotherapy was administered to patients presenting a high risk of recurrence.
  • Ten patients were subject to recurrences between 7 and 54 months after treatment.
  • CONCLUSION: Tailored adjuvant postoperative chemoradiotherapy is able to obtain a satisfactory clinical outcome in patients with high-risk early-stage IB cervical cancer.
  • [MeSH-major] Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Postoperative Care. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 19846974.001).
  • [ISSN] 1791-7530
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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2. Cai HB, Chen HZ, Yin HH: Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res; 2006 Jun;32(3):315-23
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  • [Title] Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer.
  • AIM: To determine the most effective treatment and long-term outcome of patients with stage IB carcinoma of the cervix.
  • METHODS: From January 1999 to December 2001, 106 women with cervical cancer stage IB received neoadjuvant chemotherapy (n = 52) or primary surgery (n = 54).
  • Surgery revealed positive nodes in 9.6% neoadjuvant chemotherapy group patients and in 29.6% primary surgery group patients (P = 0.014).
  • Similar results occurred with vascular space involvement: 27.8% in the primary surgery group compared to 9.6% in the neoadjuvant chemotherapy group (P = 0.024).
  • However, parametrial infiltration was found in 7.4% of the patients in the primary surgery group, while only 3.8% showed it in the neoadjuvant chemotherapy group (P = 0.679).
  • The overall 5-year survival rate was significantly higher for all patients who received neoadjuvant chemotherapy (84.6%) than for the control group (75.9%) (P = 0.0112).
  • The median survival time in patients with complete response and partial response to chemotherapy (83.3 months) was significantly higher than that of patients with stable disease to chemotherapy (55.2 months) (P = 0.0049).
  • 27.3% of patients developed recurrent disease within 5 years of the primary treatment.
  • CONCLUSION: Neoadjuvant chemotherapy can effectively eliminate the pathological risk factors and improve long-term survival in patients with locally advanced cervical cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Neoadjuvant Therapy. Prospective Studies. Survival Analysis

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  • (PMID = 16764623.001).
  • [ISSN] 1341-8076
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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3. Martín-Martínez A, Molano F, Lloret M, Falcón-Vizcaino O, García-Hernández JA: Concurrent chemotherapy and radiotherapy for cervical cancer. Eur J Gynaecol Oncol; 2003;24(2):160-2
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  • [Title] Concurrent chemotherapy and radiotherapy for cervical cancer.
  • OBJECTIVE: To compare the results obtained following treatment, from a group of patients with locally advanced cervical cancer (Stage IB or higher) treated with concurrent chemotherapy and radiotherapy in relation to a group of patients treated exclusively with radiotherapy.
  • MATERIAL AND METHOD: All patients treated with concurrent chemotherapy and radiotherapy at the Gynaecologic Oncology Unit of the University Hospital Materno Infantil of the Canaries between 1999 and 2000, both inclusive, were included.
  • The first group to be considered was formed by patients who received combined treatment.
  • The results were compared in relation to survival in the two following years from treatment (2000-2001) in the group of combined treatment and years 1999-2000 in the group that received only radiotherapy.
  • RESULTS: The groups compared are homogeneous when looking at the stage of the disease when diagnosed, the histological type of tumour and its degree of cellular differentiation, the CAT results and tumoral markers.
  • Survival of more than two years was observed in the group treated with concurrent chemotherapy and radiotherapy in relation to the group treated exclusively with radiotherapy; chi-square 9.92, p < 0.01, OR: 0.1 (0.01-0.6).
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Middle Aged. Radiation Dosage. Treatment Outcome


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4. Petsuksiri J, Chansilpa Y, Therasakvichya S, Suntornpong N, Thephamongkhol K, Dankulchai P, Mahasitthiwat P, Ieumwananonthachai N, Veerasarn V, Sangruchi S, Pattaranutaporn P: Treatment options in bulky stage IB cervical carcinoma. Int J Gynecol Cancer; 2008 Nov-Dec;18(6):1153-62
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment options in bulky stage IB cervical carcinoma.
  • Cervical cancer is the most common female cancer in the developing countries.
  • Treatments of bulky stage IB cervical cancer have been challenged as the local control is relatively poor compared to smaller stage I disease, whether treated by radical surgery or irradiation.
  • The treatment options are definitive concurrent chemoradiation therapy or radical surgery with or without neoadjuvant or adjuvant therapy.
  • The treatment decision is based on the patients' status and preferences, tumor characteristics, and experiences of clinician.
  • This study will review and compare the treatment modalities and rationales of a combination of treatment including surgery, radiation therapy, and chemotherapy for bulky stage IB cervical carcinoma.
  • [MeSH-major] Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / classification. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adenocarcinoma / therapy. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Hysterectomy. Neoplasm Staging

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  • [CommentIn] Int J Gynecol Cancer. 2009 Apr;19(3):480 [19407578.001]
  • (PMID = 18298563.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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5. Manchana T, Triratanachat S, Sirisabya N, Vasuratna A, Termrungruanglert W, Tresukosol D: Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer. Gynecol Oncol; 2006 Mar;100(3):556-60
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer.
  • OBJECTIVES: To evaluate the prevalence of cyclooxygenase-2 (COX-2), correlation with various clinicopathologic factors and prognostic significance of COX-2 in stage IB cervical cancer patients.
  • METHODS: 89 paraffin-embedded specimens of patients with stage IB cervical cancer underwent radical hysterectomy and pelvic lymphadenectomy at King Chulalongkorn Memorial Hospital during 1 January 1997-31 December 2002 and were stained with polyclonal goat antiserum against COX-2 using immunohistochemical method.
  • RESULTS: The prevalence of positive COX-2 expression in stage IB cervical cancer in this study was 49.4%.
  • Positive COX-2 expression in cervical adenocarcinoma was higher than squamous cell carcinoma (86.7% versus 40.6%, P < 0.05) and significantly expressed when lymph node metastasis was presented (100% versus 46.4%, P < 0.05).
  • CONCLUSIONS: Strong correlation was found in cervical adenocarcinoma and lymph node metastasis.
  • However, COX-2 expression failed to demonstrate as a significant prognostic factor in stage IB cervical cancer.
  • [MeSH-major] Cyclooxygenase 2 / biosynthesis. Uterine Cervical Neoplasms / enzymology
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / enzymology. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / enzymology. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Disease-Free Survival. Female. Humans. Immunohistochemistry. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging

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  • (PMID = 16246405.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] EC 1.14.99.1 / Cyclooxygenase 2
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6. Mossa B, Mossa S, Corosu L, Marziani R: Follow-up in a long-term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma. Eur J Gynaecol Oncol; 2010;31(5):497-503
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Follow-up in a long-term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma.
  • OBJECTIVE: To assess the role of neoadjuvant chemotherapy to achieve radical surgery in a larger number of patients with locally advanced/or bulky Stage IB cervical carcinoma.
  • We conducted a trial to determine whether neoadjuvant chemotherapy would improve disease-free survival and overall survival in Stage IB-III cervical cancer.
  • METHODS: 288 patients with squamous cell carcinoma of the uterine cervix, FIGO Stage IB-IIIB were randomized to one of the following treatments: three courses of neoadjuvant chemotherapy with cisplatin, vincristine, bleomycin (NACT arm; n = 159); conventional surgery or exclusive radiotherapy (CONV arm; n = 129).
  • There was no difference in age, FIGO stage, tumor size and lymph node involvement between the two groups (p = ns).
  • Two hundred and thirty-four patients in Stage IB-IIb (n = 129 NACT arm and n = 105 CONV arm) and 24 patients in Stage III (NACT arm) who proved to be chemosensitive underwent radical hysterectomy.
  • Six Stage III patients, non responders to chemotherapy, and 24 patients, Stage III of the CONV arm, underwent radiotherapy.
  • RESULTS: The study was performed on disease-free survival related to several prognostic factors: age, FIGO stage, tumor size, grading, parametrial involvement, lymph node status and surgical margins.
  • Statistically significant differences in the recurrence of the disease were related to FIGO stage (p < 003), grading (p < .05), parametrial involvement (p < .002) lymph node status (p < .0001) and tumor size (p <.002).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Hysterectomy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Middle Aged. Neoadjuvant Therapy. Radiotherapy. Vincristine / administration & dosage


7. Kim HS, Kim JY, Park NH, Kim K, Chung HH, Kim YB, Kim JW, Kim HJ, Song YS, Kang SB: Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer. Gynecol Oncol; 2010 Nov;119(2):217-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer.
  • OBJECTIVE: To evaluate whether neoadjuvant chemotherapy before surgery (NCS) is more efficient than primary surgical treatment (PST) for improving clinical outcomes in FIGO stage IB1-IIA cervical cancer.
  • Patients with ≥2 intermediate- or ≥1 high-risk factors received adjuvant concurrent chemoradiation using cisplatin-based chemotherapy.
  • RESULTS: NCS reduced more definitely intermediate- and high-risk factors than PST in stage IIA disease in spite of little difference of them in stage IB disease (large tumor size, 25% vs. 52.4%; deep stromal invasion, 57.1% vs. 82.1%; lymphovascular space invasion, 35.7% vs. 65.5%; parametrial invasion, 17.9% vs. 41.7%; p<0.05).
  • Moreover, ≥2 intermediate-risk factors were less common in NCS than PST despite no difference of the number of high-risk factors between the 2 treatments, which decreased the need of adjuvant radiotherapy in patients with stage IIA disease who received NCS (46.4% vs. 84.5%, p<0.01).
  • Although there were no differences in progression-free survival and disease recurrence between the 2 treatments, NCS led to poorer overall survival than PST in stage IIA disease with no difference of it in stage IB disease.
  • CONCLUSIONS: The efficacy between NCS and PST may be similar in FIGO stage IB cervical cancer.
  • However, NCS can lead to poor prognosis despite the reduction of intermediate-risk factors and the need of adjuvant radiotherapy in FIGO stage IIA disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Hysterectomy. Lymph Node Excision. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Paclitaxel / administration & dosage. Risk Factors. Survival Rate


8. Aubard Y, Genet D, Philippe HJ: [Caring for stage IB cancer of the cervix. Proposal for a protocol based on a review of the literature]. Gynecol Obstet Fertil; 2003 Jan;31(1):2-13
International Agency for Research on Cancer - Screening Group. diagnostics - A practical manual on visual screening for cervical neoplasia .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Caring for stage IB cancer of the cervix. Proposal for a protocol based on a review of the literature].
  • [Transliterated title] Prise en charge du cancer du col utérin au stade IB. Proposition d'un protocole fondé sur une revue de la littérature.
  • A review of the literarure indicates that there are two essential prognostic factors in stage Ib cancer of the cervix: the size of the tumour (determined by a physical examination and MRI) and invasion of the lymph nodes (determined by lymphadenectomy).
  • Of the available means of treatment, many workers use surgery at stage Ib1 and a combination of chemotherapy and radiotherapy at stage Ib2.
  • Hence, our pre-therapeutic assessment usually includes a physical examination under general anaesthesia, MRI of the abdomen and pelvis, and laparoscopic pelvic lymphadenectomy for stage Ib1 and laparoscopic lumbo-aortic lymphadenectomy for stage Ib2.
  • For stage Ib1 < 2 cm, if extemporaneous examination of the pelvic lymph nodes is positive, we perform lymphadenectomy of the lumbo-aortic lymph nodes and initiate treatment with chemotherapy and radiotherapy.
  • If the margins are healthy and devoid of vascular or lymphatic involvement, no further treatment is given.
  • If this is not the case, we suggest a postoperative radio-chemotherapy.
  • For tumours measuring between 2 and 4 cm, and if pelvic lymphadenectomy is positive, we propose radio-chemotherapy, or radical hysterectomy as for small tumours.
  • For Ib2 tumours, and if no lumbar adenopathy is seen at MRI, we perform a lumbo-aortic lymphadenectomy, followed by a radio-chemotherapy.
  • If invasion of lumbar lymph nodes is suspected at MRI, we perform a biopsy on the left scalenic lymph nodes; if invasion is present at this level, we give palliative treatment with simple pelvic radiotherapy.
  • If, at the end of combined chemotherapy and radiotherapy, some remaining tumour is discovered at the MRI assessment, we carry out extrafacial hysterectomy.
  • [MeSH-major] Antineoplastic Protocols. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Aging. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Fertility. Humans. Hysterectomy / methods. Lymph Node Excision. Lymphatic Metastasis. Magnetic Resonance Imaging. Neoplasm Staging. Prognosis. Radiotherapy

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  • [CommentIn] Gynecol Obstet Fertil. 2003 Jul-Aug;31(7-8):689 [14563617.001]
  • (PMID = 12659779.001).
  • [ISSN] 1297-9589
  • [Journal-full-title] Gynécologie, obstétrique & fertilité
  • [ISO-abbreviation] Gynecol Obstet Fertil
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 87
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9. Yu L, Tan GS, Xiang XH, Guo WB, Li HP, Huang YH, Yang JY: [Comparison of uterine artery chemoembolization and internal iliac arterial infusion chemotherapy for the combining treatment for women with locally advanced cervical cancer]. Ai Zheng; 2009 Apr;28(4):402-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Comparison of uterine artery chemoembolization and internal iliac arterial infusion chemotherapy for the combining treatment for women with locally advanced cervical cancer].
  • BACKGROUND AND OBJECTIVE: Uterine artery chemoembolization (UACE) and internal iliac arterial infusion chemotherapy (IAIC) are important methods to treat cervical cancer.
  • This study was to evaluate the curative effects of UACE and IAIC on the combining treatment for women with locally advanced cervical cancer.
  • METHODS: One hundred and seventy-five patients with locally advanced cervical cancer treated between April 1997 and November 2007 were retrospectively analyzed.
  • The UACE group was treated by bilateral uterine artery chemoembolization.
  • The IAIC group was treated by bilateral internal iliac arterial infusion chemotherapy.
  • All patients were treated by carboplatin-based combining chemotherapy.
  • The effective rate for clinical stage IB cervical cancer in the UACE group was 77.8%, which was significantly higher than 41.2% in the IAIC group (P=0.037).
  • However, for clinical stage II,III cervical cancer, the effective rates between the two groups had no significant differences (P=0.137 and P=0.524).
  • Postoperative pathologic examinations showed that the negative percentages of cancer cell residue and pelvic lymph node metastasis in the UACE group were slightly higher than those in the IAIC group (17.2% and 80.6% vs. 12.9% and 79.4%, P=0.504 and P=0.861).
  • CONCLUSIONS: UACE followed by preoperative radiotherapy can more effectively reduce the tumor volume of locally advanced cervical cancer compared with IAIC.
  • But UACE does not increase the pathological complete response rate and not decrease the pelvic lymph node metastasis rate, the postoperative recurrence rate, and tumor embolus within lymphovascular space.The effect of UACE on the long-term survival of locally advanced cervical cancer needs to be further evaluated.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Chemoembolization, Therapeutic. Infusions, Intra-Arterial. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Carboplatin / administration & dosage. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Iliac Artery. Iridium Radioisotopes / therapeutic use. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Neoplasm, Residual. Remission Induction. Retrospective Studies. Tumor Burden. Uterine Artery. Young Adult


10. Whitney CW, Stehman FB: The abandoned radical hysterectomy: a Gynecologic Oncology Group Study. Gynecol Oncol; 2000 Dec;79(3):350-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: The aim of this study was to evaluate the frequency with which intended radical hysterectomy for cervical cancer is abandoned and the outcomes for those patients.
  • There were 1127 patients with Stage IB carcinoma of the cervix entered on Gynecologic Oncology Group Protocol No. 49.
  • Sixty-three (93%) patients subsequently underwent pelvic radiation therapy and one or two intracavitary applications.
  • Five patients received radiotherapy and chemotherapy; 4 patients received chemotherapy alone.
  • One patient declined any further therapy.
  • The disease-free survival was shorter for patients whose radical procedure was abandoned than for those patients who underwent radical hysterectomy.
  • CONCLUSIONS: Retrospective comparisons of radical hysterectomy to radiation therapy are not valid unless the group of patients whose radical operation was abandoned is included.
  • The morbidity of the operation is low even when followed by radiation therapy.
  • However, no recommendations for optimal therapy can be made from this analysis.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Hysterectomy. Uterine Cervical Neoplasms / surgery

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 11104604.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA12484; United States / NCI NIH HHS / CA / CA12534; United States / NCI NIH HHS / CA / CA27816; etc
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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11. Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, O'Connor D: Treatment of ("bulky") stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol; 2007 Aug;106(2):362-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of ("bulky") stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group.
  • OBJECTIVE: A randomized phase III trial was conducted to determine if neoadjuvant chemotherapy (NACT) prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy (RHPPL) could improve progression-free survival (PFS) and overall survival (OS), as well as operability, with acceptable levels of toxicity.
  • Adjuvant radiation therapy was prescribed for specific surgical/pathological risk factors for both regimens.
  • METHODS: Eligible patients were required to have bulky FIGO Stage IB cervical cancer, tumor diameter > or =4 cm, adequate bone marrow, renal and hepatic function, and performance status < or =2.
  • Prospective random allocation was to either NACT (vincristine-cisplatin chemotherapy every 10 days for 3 cycles) before exploratory laparotomy and planned RHPPL (NACT+RHPPL), or RHPPL only.
  • The median follow-up time is 62 months among living patients.
  • CONCLUSION: There is no evidence from this trial that NACT offered any additional objective benefit to patients undergoing RHPPL for suboptimal Stage IB cervical cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Disease-Free Survival. Female. Humans. Hysterectomy. Lymph Node Excision. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Vincristine / administration & dosage


12. Carballo N, González-Cortijo L, González-Martín A, Rojo A, Chiva L: Indications for adjuvant radiotherapy treatment after surgery and novel modalities for treatment. Gynecol Oncol; 2008 Sep;110(3 Suppl 2):S41-4
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Indications for adjuvant radiotherapy treatment after surgery and novel modalities for treatment.
  • Carcinoma of the uterine cervix is a frequent common cancer in women.
  • Patients diagnosed with early stage cervix cancer are managed with surgery.
  • Overall survival for stage IB (IB1-IB2) and IIA, is in the range of 80-90% at 5 years.
  • In the presence of 2 of the 3 adverse risk factors, radiotherapy reduces tumor recurrence in stage IB cervical cancer with negative lymph nodes.
  • Radiotherapy plays an important role in the management of cervical cancer.
  • Conventional radiotherapy may treat a large amount of normal tissue resulting in acute toxicity.
  • With standard doses of external beam radiotherapy 45 Gy-50 Gy (1.8 Gy-2 Gy) grade 3-4 late toxicity occurs in about 10%-12%.
  • Intensity modulated radiation therapy (IMRT) represents an advance in treatment delivery with doses that conform tightly to the target, and may reduce the acute gastrointestinal and chronic toxicity when compared with conventional 3D radiotherapy.
  • Also IMRT treats less bone marrow and may lead to a better tolerance of chemotherapy.
  • [MeSH-major] Uterine Cervical Neoplasms / radiotherapy

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  • (PMID = 18760712.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Lee IJ, Park KR, Lee KK, Song JS, Lee KG, Lee JY, Cha DS, Choi HI, Kim DH, Deung YK: Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys; 2002 Nov 1;54(3):768-79
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix.
  • PURPOSE: To clarify the role of vascular endothelial growth factor (VEGF) expression as an independent prognostic factor in Stage IB cervical cancer.
  • METHODS AND MATERIALS: A total of 117 patients with Stage IB cervical cancer who had undergone radical hysterectomy and pelvic lymph node dissection with complete histopathologic examination were included.
  • Eighty-eight (75.2%) patients received postoperative radiotherapy and/or chemotherapy.
  • Functional and quantitative tools to assess tumor angiogenesis in addition to the expression of VEGF need to be developed and would be helpful to support the finding that tumor angiogenesis correlates significantly with prognosis in early-stage cervical cancer.
  • [MeSH-major] Adenocarcinoma / chemistry. Carcinoma, Adenosquamous / chemistry. Carcinoma, Squamous Cell / chemistry. Endothelial Growth Factors / analysis. Intercellular Signaling Peptides and Proteins / analysis. Lymphokines / analysis. Neoplasm Proteins / analysis. Uterine Cervical Neoplasms / chemistry
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Female. Humans. Middle Aged. Prognosis. Treatment Failure. Vascular Endothelial Growth Factor A. Vascular Endothelial Growth Factors

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  • (PMID = 12377329.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Endothelial Growth Factors; 0 / Intercellular Signaling Peptides and Proteins; 0 / Lymphokines; 0 / Neoplasm Proteins; 0 / Vascular Endothelial Growth Factor A; 0 / Vascular Endothelial Growth Factors
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14. Moore DH: Treatment of stage IB2 (bulky) cervical carcinoma. Cancer Treat Rev; 2003 Oct;29(5):401-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of stage IB2 (bulky) cervical carcinoma.
  • Tumour size is an important prognostic factor in patients with stage IB cervical cancer.
  • The patient with stage IB2 (bulky) cervical cancer represents a therapeutic challenge.
  • Neither radical hysterectomy nor primary radiation therapy are sufficiently effective and are associated with significant treatment-related complications including ovarian failure and psychosexual deficits.
  • It appears that extrafascial hysterectomy following radiation therapy does not improve overall survival relative to radiation therapy alone.
  • Consistent with results seen in locally advanced cervical carcinoma, chemoradiation therapy is superior to radiation therapy alone as primary treatment for stage IB2 cervical cancer and as adjuvant therapy for surgically treated patients with high-risk factors for recurrence.
  • Neoadjuvant chemotherapy has resulted in high clinical response rates and operability rates.
  • There are two phase III trials suggesting an improvement in survival with neoadjuvant chemotherapy followed by radical hysterectomy versus either surgery (and selected postoperative radiation) or radiation therapy alone.
  • These emerging treatments should be scrutinized in prospective controlled trials.
  • [MeSH-major] Hysterectomy / methods. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Biopsy, Needle. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Middle Aged. Neoadjuvant Therapy / methods. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 12972358.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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15. Grigsby PW: Cervical cancer: combined modality therapy. Cancer J; 2001 Jul-Aug;7 Suppl 1:S47-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cervical cancer: combined modality therapy.
  • Prospective, randomized studies conducted over the past 10 years have changed the management of patients with advanced cervical cancer.
  • The reviewed studies evaluated the use of surgery, irradiation, and chemotherapy in patients with various stages of cervical carcinoma in the absence and presence of high-risk factors for recurrence.
  • A study by the Radiation Therapy Oncology Group (RTOG) compared pelvic with pelvic plus prophylactic para-aortic irradiation in patients with stages IB (> 4 cm), IIA, and IIB cervical cancer.
  • A follow-up study compared pelvic plus prophylactic para-aortic irradiation and brachytherapy with pelvic irradiation, brachytherapy, and chemotherapy with cisplatin and 5-FU in patients with IB-to IVA-stage cervical cancer.
  • Overall and disease-free survivals were significantly improved in patients receiving chemotherapy.
  • In patients with a prevalence of stage IIB and III, the Gynecologic Oncology Group (GOG) demonstrated that treatment with hydroxyurea alone was inferior to cisplatin or cisplatin, 5-FU, and hydroxy-urea in patients treated concurrently with pelvic irradiation and brachytherapy, and the GOG adopted irradiation and weekly cisplatin as standard therapy.
  • Further GOG studies suggest that irradiation and weekly cisplatin chemotherapy without hysterectomy is the optimal treatment for patients with stage IB cervical cancer.
  • Prospective, randomized studies conducted by the GOG evaluated the effectiveness of various treatments in patients with high-risk factors.
  • In one study that did not use chemotherapy, the recurrence-free interval was about 10% better for stage IB patients receiving postoperative irradiation after radical hysterectomy and pelvic lymphadenectomy compared with those who received no further therapy.
  • Patients with Stages IB and IIA disease who, following radical hysterectomy and lymph node dissection, are identified as having positive pelvic lymph nodes and positive parametrial involvement, are at higher risk for recurrence and death than the high-risk group described above.
  • An intergroup study conducted by the GOG, RTOG, and Southwest Oncology Group compared postoperative pelvic irradiation alone with postoperative pelvic irradiation plus concurrent chemotherapy in this group of patients.
  • Overall and progression-free survivals were superior for patients receiving chemotherapy, and their greatest survival occurred in patients who received 3 or 4 chemotherapy cycles compared with 1 or 2 cycles or no chemotherapy.
  • These findings are summarized with respect to their implications fortreatment of patients with advanced cervical cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Hysterectomy. Risk Factors

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  • (PMID = 11504285.001).
  • [ISSN] 1528-9117
  • [Journal-full-title] Cancer journal (Sudbury, Mass.)
  • [ISO-abbreviation] Cancer J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 8
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16. Rutledge TL, Kamelle SA, Tillmanns TD, Gould NS, Wright JD, Cohn DE, Herzog TJ, Rader JS, Gold MA, Johnson GA, Walker JL, Mannel RS, McMeekin DS: A comparison of stages IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference? Gynecol Oncol; 2004 Oct;95(1):70-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A comparison of stages IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference?
  • OBJECTIVE: To compare stages IB1 and IB2 cervical cancers treated with radical hysterectomy (RH) and to define predictors of nodal status and recurrence.
  • METHODS: Patients with stage IB cervical cancers undergoing RH between 1990 and 2000 were evaluated and clinicopathological variables were abstracted.
  • The perioperative complication rate, estimated blood loss (EBL), and OR time were also tabulated.
  • RESULTS: RH was performed on 109 stage IB1 and 86 stage IB2 patients.
  • Univariate predictors of nodal status included lymphovascular space involvement (LVSI) (P = 0.001), DOI (P = 0.011), PI (P = 0.001), and stage (P = 0.011).
  • Neoadjuvant chemotherapy, age, grade, histology, and adjuvant radiation were not associated with recurrence.
  • CONCLUSIONS: The prognosis in stage IB cervical cancer seems to be most influenced by presence of LVSI and DOI and not by tumor size as the staging criteria would suggest.
  • Treatment decisions based on tumor size alone should be reconsidered.
  • [MeSH-major] Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy / adverse effects. Hysterectomy / methods. Lymph Node Excision / adverse effects. Lymph Node Excision / methods. Lymph Nodes / pathology. Lymph Nodes / surgery. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Risk Factors. Treatment Outcome






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