Carcinoma of the cervix treated with radiation therapy I: a multi-variate analysis of prognostic variables in the Gynecologic Oncology Group

Article Abstract:

In patients with locally advanced cervical cancer, cancer cells have spread from the primary cancer in the cervix to lymph nodes in the pelvic area, particularly the para-aortic lymph nodes in the back near the aorta. Such patients have a high risk of cancer recurrence after surgery, and radiotherapy is the mainstay of treatment for these patients. As a part of research evaluating the treatment of cervical cancer, data were collected from 626 patients with primary carcinoma of the cervix; all had surgical evaluation of the para-aortic lymph nodes and received radiation therapy. These data were analyzed to determine which factors bear most strongly on the risk of recurrence and upon the likelihood of long-term survival from this cancer. The data analysis revealed that the para-aortic lymph nodes were an especially strong prognostic factor. In most forms of cancer, the spread of cancer cells to neighboring lymph nodes indicates a worse prognosis. In the case of cervical cancer, the spread of cancer cells to the pelvic lymph nodes doubles the risk of suffering recurrence and dying within a given time. However, if cancer cells are found in the para-aortic lymph nodes, the relative risk of recurrence is 11 times greater and the relative risk of dying is over six times as great. It is important to always obtain pathological information on the para-aortic lymph nodes in cases of cervical cancer, as this is the single most meaningful prognostic factor. As would be expected, larger cancers and more advanced cancers are also significantly associated with an increased risk of recurrence and death. When conducting clinical trials of treatment programs for cervical cancer, the failure to pathologically examine the para-aortic lymph nodes would result in considering together patients with drastically different prognoses; this would very likely make interpretation of the effects of treatment difficult or impossible. In the present series of patients, two-thirds of the patients who have been followed for at least five years have died. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Prognosis, Identification and classification, Tumors, Pathology, Gynecological, Gynecological pathology

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Sites of failure and times to failure in carcinoma of the vulva treated conservatively: a Gynecologic Oncology Group study

Article Abstract:

Cancer of the vulva may recur later than cancer of the groin after conservative treatment and may be less lethal than groin cancer. A Gynecologic Oncology Group study of 143 patients who had surgery to excise invasive squamous cell cancer of the vulva found that 37 patients experienced a recurrence of cancer. Twenty-one of the patients with recurrences experienced another cancer on the vulva and 12 had groin cancers. The average time to recurrence of vulvar cancer was 13.7 months versus 6.1 months for recurrences in the groin. Vulvar recurrences of cancer may not be found near the site of the original cancer, and could be new cancers. Groin recurrences of cancer may indicate continuing disease near the original site of cancer and be fatal.

Surgery, Cancer, Cancer recurrence, Vulvar cancer

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Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma

Article Abstract:

Cisplatin chemotherapy combined with radiation treatment may improve the prognosis of cervical cancer. Researchers randomly assigned 369 women with stage IB cervical cancer to receive radiation treatment alone or radiation plus chemotherapy with cisplatin. All the women also had a hysterectomy. Combination treatment with cisplatin and radiation cut the risk of disease progression in half. Four-year survival rates were higher in the women who received combination therapy. However, these women were more likely to have side effects from the treatment.

Care and treatment, Evaluation, Radiotherapy, Cisplatin

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