The influence of some clinical and morphological prognosis factors on the 5-year survival of patients with stage I cervical cancer
https://doi.org/10.17709/2409-2231-2019-6-4-3
Abstract
Purpose of the study. To analyze the treatment long-term results of patients with cervical cancer (CC) depending on the clinical and morphological characteristics of the disease.
Patients and methods. 75 patients with stage I cervical cancer at the age of 21 to 76 years, were included in this retrospective study. All patients have been operated at the first stage of treatment in the Orenburg Regional Clinical Oncology Center from 2008 to 2013. Patient data was obtained from patient card and the "cancer-register". The statistical analis of the results was performed using the Statistica 6 software.
Results. Recurrence of disease was detected in 7 patients and 7 patients died after treatment. 5-year relapse-free survival (RFS) and overall survival (OS) were 90,3%. 5-year RFS was: 95.2% and 66.0% — in depth of invasion of 10 mm or less and more than 10 mm (p=0.0004); 94.4% and 89.5% — in stages IA and IB (p>0.4) and 80.6% and 97.6% — in the presence and absence of adjuvant radiation therapy (p=0.002), respectively. 5-year OS was: 96.7% and 47.0% — in depth of invasion of 10 mm or less and more than 10 mm (p=0.00001); 97.0% and 84.2% — in stages IA and IB (p=0.07); 80.6% and 97.6% — in the presence and absence of adjuvant radiation therapy (p=0.02), respectively. There were no recurrence in 11 patients with IB stage, who did not receive adjuvant RT and, but ones were observed in 6 patients with stage IA — IB, who received the adjuvant RT.
Conclusion. These results indicate that the use of only clinical and morphological factors is not sufficient to accurately assess of the CC prognosis and the search for new markers of the CC recurrence risk has not lost its relevance.
About the Authors
E. V. MakarovaRussian Federation
Elena V. Makarova - graduate student of department of radiation diagnosis, radiotherapy, oncology Orenburg State Medical University of Ministry of Health of Russia; doctor in the department of ultrasound diagnostics Orenburg Regional Clinical Oncology Dispensary.
6 Sovetskaya str., Orenburg 460000; 11 Gagarin ave., Orenburg 460021.
M. A. Senchukova
Russian Federation
Marina A. Senchukova - MD, PhD, DSc, professor of the department of radiation diagnostics, radiation therapy, oncology Orenburg State medical university; doctor of the department of thoracic surgery Orenburg Regional Clinical Oncology Center.
6 Sovetskaya str., Orenburg 460000; 11 Gagarin ave., Orenburg 460021.
References
1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics 2012. CA Cancer J Clin. 2015 Mar; 65(2):87—108. DOI: 10.3322/caac.21262
2. The state of cancer care in Russia in 2017. Edited by Kaprin AD, Starinsky VV, Petrova GV. Moscow: P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation; 2018, 236 p. (In Russian).
3. Zhurman VN, Eliseeva EV, Gulevich AP, Slobodenyuk EV. So-cio-economic effects of women mortality from female genitals malignant tumors. Far East Medical Journal. 2016, 1:89-91. (In Russian).
4. Wiebea E, Dennyb L, Thomasa G. FIGO cancer report 2012. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2012 Oct; 119(S2):100-109. DOI: 10.1016/S0020-7292(12)60023-X
5. Kravets OA, Kuznetsov VV, Morkhov KY, Nechushkina VM, HohlovA SV. Cervical Cancer. Clinical recommendations for diagnosis and treatment. Ministry of health of the Russian Federation, Moscow. 2018, 44 p. (In Russian). Available at: http://www.oncology.ru/association/clinical-guidelines/2018/rak_sheiki_matki_pr2018.pdf
6. Proshin AA, Berezovskaya TP, Krikunova LI, Shavladze ZN. Cancer of the cervix uteri: magnetic resonance and clinical factors of prognosis. Diagnosis of reproductive system tumors. 2012; 3 (4):102-107. (In Russian).
7. Miyauchi R, Itoh Y, Kawamura M, Hirakawa A, Shibata K, Kajiyama H, et al. Postoperative chemoradiation therapy using high dose cisplatin and fluorouracil for high- and intermediate-risk uterine cervical cancer. Nagoya J Med Sci. 2017 Feb; 79(2):211-220. DOI: 10.18999/nagjms.79.2.211
8. Atahan IL, Onal C, Ozyar E, Yiliz F, Selek U, Kose F. Long-term outcome and prognostic factors in patients with cervical carcinoma: a retrospective study. Int J Gynecol Cancer. 2007 Jul-Aug; 17 (4):833-842. DOI: 10.1111/j.1525-1438.2007.00895.x
9. Marnitz S, Kohler C, Affonso RJ, Schneider A, Chiantera V, Tsounoda A, et al. Validity of Laparoscopic Staging to Avoid Adjuvant Chemoradiation following Radical Surgery in Patients with Early Cervical Cancer. Oncology. 2012; 83(6):346-353. DOI: 10.1159/000341659
10. Hou Y, Guo S, Lyu J, Lu Z, Yang Z, Liu D, et al. Prognostic factors in Asian and white American patients with cervical cancer, alone, a retrospective evaluation. Eur J Surg Oncol. 2016 Mar; 42 (3):376-382. DOI: 10.1016/j.ejso.2015.12.003
11. Shimamoto K, Saito T, Kitade S, Tomita Y, Nagayama R, Yamaguchi S, et al. A study of treatments and outcomes in elderly women with cervical cancer. Eur J Obstet Gynecol Reprod Biol. 2018 Sep; 228:174-179. DOI: 10.1016/j.ejogrb.2018.06.032
12. Landoni F, Colombo A, Milani R, Placa F, Zanagnolo V, Mangioni C. Randomized study between radical surgery and radiotherapy for the treatment of stage IB-IIA cervical cancer: 20-year update. J Gynecol Oncol. 2017 May; 28(3):34. DOI: 10.3802/jgo.2017.28.e34
13. Noh JM, Park W, Kim YS, Kim JY, Kim HJ, Kim J, et al. Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy: a multicenter retrospective study (KROG 13-10). Gynecol Oncol. 2014 Mar; 132(3):618-623. DOI: 10.1016/j.ygyno.2014.01.043
14. Gadducci A, Guerrieri ME, Cosio S. Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables. Crit Rev Oncol Hematol. 2019 Mar; 135:103-114. DOI: 10.1016/j.critrevonc.2019.01.006
15. Wu SG, Zhang WW, He ZY, Sun JY, Wang Y, Zhou J. Comparison of survival outcomes between radical hysterectomy and definitive radiochemotherapy in stage IB1 and IIA1 cervical cancer. Cancer Manag Res. 2017 Dec 11; 9:813-819. DOI: 10.2147/CMAR.S145926
16. Tang M, Liu Q, Yang X, Chen L, Yu J, Qi X, et al. Perineural invasion as a prognostic risk factor in patients with early cervical cancer. Oncol Lett. 2019 Jan; 17(1):1101-1107. DOI: 10.3892/ol.2018.9674
17. Liu YM, Ni LQ, Wang SS, Lv QL, Chen WJ, Ying SP. Outcome and prognostic factors in cervical cancer patients treated with surgery and concurrent chemoradiotherapy: a retrospective study. World J Surg Oncol. 2018 Jan 29; 16(1):18. DOI: 10.1186/s12957-017-1307-0
18. Lee HN, Mahajan MK, Das S, Sachdeva J, Tiwana MS. Early hematological effects of chemo-radiation therapy in cancer patients and their pattern of recovery — a prospective single institution study. Gulf J Oncolog. 2015 Jan; 1(17):43-51.
19. Bishop AJ, Allen PK, Klopp AH, Meyer LA, Eifel PJ. Relationship between low hemoglobin levels and outcomes after treatment with radiation or chemoradiation in patients with cervical cancer: has the impact of anemia been overstated? Int J Radiat Oncol Biol Phys. 2015 Jan 1; 91(1):196-205. DOI: 10.1016/j.ijrobp.2014.09.023
20. Hong CM, Park SH, Chong GO, Lee YH, Jeong JH, Lee SW, et al. Enhancing prognosis prediction using pre-treatment nodal SUVmax and HPV status in cervical squamous cell carcinoma. Cancer Imaging. 2019 Jun 24; 19(1):43. DOI: 10.1186/s40644-019-0226-4
21. Zuo J, Huang Y, An J, Yang X, Li N, Huang M, et al. Nomograms based on HPV load for predicting survival in cervical squamous cell carcinoma: An observational study with a long-term follow-up. Chin J Cancer Res. 2019 Apr; 31(2):389-399. DOI: 10.21147/j.issn.1000-9604.2019.02.13
22. Chen L, Zhang WN, Zhang SM, Gao Y, Zhang TH, Zhang P. Class I hysterectomy in stage Ia2-Ib1 cervical cancer. Wideochir Inne Tech Maloinwazyjne. 2018 Dec; 13(4):494-500. DOI: 10.5114/wiitm.2018.76832
23. Ma Y, Zhao G, Qi J, Sun P, Liu C, Qu P, et al. Neoadjuvant brachytherapy and chemotherapy followed by radical surgery for stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation. Mol Clin Oncol. 2018 Apr; 8(4):623-627. DOI: 10.3892/mco.2018.1580
24. Lacorre A, Merlot B, Garabedian C, Narducci F, Chereau E, Resbeut M, et al. Early stage cervical cancer: Brachytherapy followed by type a hysterectomy versus type B radical hysterectomy alone, a retrospective evaluation. Eur J Surg Oncol. 2016 Mar; 42 (3):376-382. DOI: 10.1016/j.ejso.2015.12.003
25. Karpova YuV, Vershinina MG, Kudryavceva LV. Cancer of the cervix uteri: state-of-the-art. Laboratory service. 2012; 1(1):24-35. (In Russian).
26. Guskova EA, Nerodo GA, Guskova NK, Poryvaev YuA, Chernikova NV. Factors influencing the frequency of recurrence of cervical cancer. International journal of applied and fundamental research. 2015; 10(1):87-91. (In Russian).
Review
For citations:
Makarova E.V., Senchukova M.A. The influence of some clinical and morphological prognosis factors on the 5-year survival of patients with stage I cervical cancer. Research and Practical Medicine Journal. 2019;6(4):34-44. (In Russ.) https://doi.org/10.17709/2409-2231-2019-6-4-3