Prognostic factors in stage IB squamous cervical cancer patients with low risk for recurrence

Article Abstract:

Cancers are graded or staged according to severity. Stage I cervical cancers are confined to the uterine cervix, yet they are widely variable in terms of size, location, cell characteristics, and aggressiveness. These factors influence survival rates of this type of cancer, which can vary from 60 to 90 percent. It is important to determine patients at risk for recurrence after surgery (which involves removal of the uterus, ovaries, and fallopian tubes), since treatment of recurrent cervical cancer is not very successful. While 15 percent of patients can be classified as at high risk for recurrence because of features such as lymph node involvement (spread of malignancy to the nodes), tumor cell type, or tumor size, half the treatment failures occur in low-risk patients whose lymph nodes are not involved (negative) and whose tumors appear to have been completely removed. Features which might be predictive of cervical cancer recurrence were studied in a group of 95 low-risk stage IB cervical cancer patients patients after surgery and lymph node removal. The patients' tumors were smaller than five centimeters in diameter and the lymph nodes were negative. The five-year survival rate for the patients was 89 percent. Seven of the nine recurrences were detected within two years of surgery. Only one recurrent-disease patient survived. Age, race, initial symptoms, cervical diameter, and extent of cervical involvement were assessed but did not relate to the risk of recurrence. This risk was significantly related only to the degree of cellular differentiation, a measure of the extent to which cancer cells lose the features of normal cells. Poorly differentiated tumors were associated with an 84 percent survival rate, while survival among patients with moderately- or well-differentiated tumors was 94 percent. Since, however, almost half of the patients without recurrences also had poorly differentiated cancers, this criterion cannot be used as a reliable indicator of outcome, and the use of adjuvant therapy (such as radiation) for all low-risk patients could lead to overtreatment in many cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Prognosis, Cervical cancer, Adjuvant chemotherapy, Cancer recurrence

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Treatment of fallopian tube carcinoma with cisplatin, doxorubicin, and cyclophosphamide

Article Abstract:

A prospective study was carried out to examine the effectiveness of chemotherapy against carcinoma of the fallopian tube (the tube through which the female egg travels en route to the uterus). This is a rare form of cancer, representing less than 2 percent of gynecologic malignancies, and the lack of significant numbers of patients has made evaluation of treatment difficult. The chemotherapeutic approach used is similar to that for ovarian cancer; removal of the uterus, both fallopian tubes, and additional tissue, followed by treatment with cisplatin, doxorubicin, and cyclophosphamide. Patients underwent chemotherapy at least six times, a regimen administered every 28 days. A complete response to treatment was defined as the disappearance of signs of the tumors for at least four weeks, with a partial response defined as a 50 percent decrease in tumor size. Results of studying 18 patients who were in various stages of disease indicated that 11 had no signs of disease when chemotherapy began. Seven had measurable lesions; of these, two had a complete response, two remained stable, and three experienced disease progression. Four of the eight patients in stage II, III, or IV disease who underwent subsequent surgery were disease-free; two had small amounts of disease, and the others had extensive disease. The average survival for the group as a whole was 81 months. For women with stage II, III, or IV disease, average survival was 43.9 months. Survival data concerning the patients without signs of disease when chemotherapy started have not yet been accrued; survival for those with measurable disease was 29.3 months. The patients had moderate toxicity reactions. Carcinoma of the fallopian tube is so rare that this group of 18 patients took 9 years to gather. Thus, evaluation of treatment success is difficult. It is not known if hormonal treatment, radiation, or other procedures are effective. Well-designed studies of the development and progression of this disease are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Genital cancer, Urogenital cancer, Chemotherapy, Combination, Combination chemotherapy

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Re-treatment of patients with recurrent epithelial ovarian cancer with cisplatin-based chemotherapy

Article Abstract:

The anticancer drug cisplatin can bring about remission of ovarian cancer. When ovarian cancer recurred in 19 patients who had previously been treated for the disease with cisplatin, they were treated again with the same cisplatin-based therapy. Most of the patients had remained free of cancer for over two years before the relapse was diagnosed. A second treatment with cisplatin-based drugs was successful in all the patients with measurable disease. Re-treatment with cisplatin-based chemotherapy is recommended for patients with recurrent ovarian cancer if they responded favorably to the drug therapy for their earlier bout with the same cancer.

Health aspects, Antineoplastic agents, Ovarian tumors, Cisplatin

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