Recurrence Of Early Cervical Cancer Research Articles

Morphological Characteristics and Clinical Significance of Different Types of Tumor Vessels in Patients with Stages I-IIA of Squamous Cervical Cancer.

The determination of factors associated with progression of cervical cancer is important, both for a recurrence risk assessment and for determining optimal treatment tactics. Previously, we showed the prognostic value of different types of tumor microvessels (MVs) in gastric and breast cancer. The object of this research was to study the morphology and clinical significance of different tumor microvessels in early cervical cancer. A total of 65 archived paraffin blocks of patients with I-IIA stages of squamous cervical cancer were investigated. Samples were stained with Mayer hematoxylin and immunohistochemically using antibodies to CD34, podoplanin, HIF-1a, and Snail. The eight types of tumor MVs differed in morphology were identified. It was established that only the dilated capillaries (DСs) with weak expression of CD34, the contact type DCs, the capillaries in tumor solid component, and the lymphatic vessels in the lymphoid and polymorphic cell infiltrates of tumor stroma are associated with clinical and pathological characteristics of early cervical cancer. Preliminary results also suggest that a combination of fragmentation in tumor solid component and the contact type DCs may predict a recurrence of early cervical cancer. Given the small number of cervical cancer recurrences, the predictive significance of the described markers requires a more thorough examination.

PET/CT imaging analysis of recurrent sites and patterns of spread following modified radical surgery (type B) for stage Ib-IIa cervical cancer.

The aim of the present study was to use imaging to retrospectively analyze the recurrent sites and patterns of spread of early cervical cancer following radical surgery. A total of 86 patients with cervical cancer (stage IB or IIA) showed postoperative pelvic recurrences and distant metastases. Based on positron emission tomography or computed tomography, the correlation between clinicopathologic factors and sites of recurrence was determined and the pattern of spread was evaluated. Among the 86 patients with postoperative recurrence of early cervical cancer, 76 exhibited pelvic recurrence involving the cardinal and uterosacral ligaments. Other recurrences were paravaginal (n=14) and vaginal (n=10). Seven cases of recurrence were in the pelvic lymph nodes and 10 patients had distant metastases. The rate of paracervical ligament recurrence in patients with stromal invasion ≥1/2 depth was higher, compared with that in patients with stromal invasion <1/2 depth, however, the difference was not statistically significant. The rate of distant metastases in patients with positive pelvic lymph nodes was higher, compared with that in patients with negative lymph nodes (P=0.001). Recurrent lesions spread along the residual ligament to the lateral pelvic wall. It was found that, following radical surgery for early cervical cancer, recurrent tumor spread was predominantly confined to the subperitoneal residual ligaments of the cervix and vagina. For patients with positive lymph nodes, the incidence of distant metastases increased significantly.

Clinical effect and influence on fertility outcomes of vaginal radical trachelectomy in young patients with early stage of cervical cancer

Objective To explore clinical effect and effect on fertility outcomes of vaginal radical trachelectomy (VRT) in young patients with early stage of cervical cancer. Methods Sixty cases of young patients with early stage of cervical cancer treated with radical trachelectomy in our hospital between June 2005 and May 2014 were retrospectively analyzed and conducted follow-up visits. The patients were divided into two groups based on different operation methods: VRT group (n=32) and abdominal radical trachelectomy (ART) group (n=28). The clinical effects and fertility outcomes of the two groups were compared. Results The blood loss of VRT group was significantly lesser than that of ART group [(278.00±97.00)ml vs. (496.00±135.00)ml, t=7.247, P<0.05]. The length of vaginal hysterectomy and the width of parametrial resection of VRT group were significantly shorter than those of ART group [(2.58±0.33)cm vs. (3.01±0.19)cm, t=6.277, P<0.05; (2.34±0.31)cm vs. (2.88±0.25)cm, t=7.357, P<0.05]. During the follow-up visits, the recurrence rate of VRT group was significantly lower than that of ART group (3.1% vs. 25.0%, χ2=6.18, P<0.05). The recurrence of early cervical cancer was related to age (χ2=21.33, P<0.05), diameter of tumor (χ2=21.43, P<0.05), pathology (χ2=40.69, P<0.05) and operation methods (χ2=6.18, P<0.05). The pregnancy rate and fertility rate of VRT group were significantly higher than those of ART group (37.5% vs. 25.0%, χ2=15.33, P<0.05; 28.1% vs. 17.9%, χ2=10.32, P<0.05). Conclusion VRT for young patients with early cervical cancer is safe and feasible. It's worthy of clinical promotion because it can reduce operation damage and recurrence rate, and can efficiently preserve the fertility of patients. Key words: Uterine cervical neoplasms; Fertility; Radical trachelectomy

Genetic profiling to predict recurrence of early cervical cancer

ObjectiveRecurrence is the major cause of death in early cervical cancer. We compared the prediction powers for disease recurrence between the gene set prognostic model and the clinical prognostic model. Materials and methodsA gene set model to predict disease free survival was developed using the cDNA-mediated annealing, selection, extension, and ligation (DASL) assay data set from a cohort of early cervical cancer patients who had been treated with radical surgery with or without adjuvant therapy. A clinical prediction model was also developed using the same cohort, and the ability of predicting recurrence from each model was compared. ResultsAdequate DASL assay profiles were obtained from 300 patients, and we selected 12 genes for the gene set model. When patients were categorized as having a low or high risk by the prognostic score, the Kaplan–Meier curve showed significantly different recurrence rates between the two groups. The clinical model was developed using FIGO stage and post-surgical pathological findings. In multivariate Cox regression analysis of prognostic models, the gene set prognostic model showed a higher hazard ratio than that of the clinical prognostic model. ConclusionsThe genetic quantitative approach may be better in predicting recurrence in early cervical cancer patients.

Genetic profiling to predict recurrence of early cervical cancer

Objective: To compare the prediction powers for disease recurrence between a gene set prognostic model and clinical prognostic model developed in a single large population to see whether a genetic quantitative approach will have a significant prognostic role in early cervical cancer patients who underwent radical hysterectomy with or without adjuvant therapies.