Radical hysterectomy followed by tailored postoperative therapy in the treatment of stage IB2 cervical cancer: feasibility and indications for adjuvant therapy.


OBJECTIVE:To determine the outcome, complications and likelihood of requiring adjuvant therapy of patients with stage IB2 cervical cancer treated with primary radical hysterectomy and lymph node dissection. METHODS:Clinical and pathologic data between 1985 and 1999 were reviewed. Associations between clinical and pathologic variables were tested using the Fisher's exact test. Survival was estimated using the Kaplan-Meier method with significance being calculated using the Log Rank test. RESULTS:Six hundred radical hysterectomies were performed during the study period. Fifty-eight of these women (9.6% of all radical hysterectomies) were diagnosed with FIGO stage IB2 cancers. Sixteen patients (28%) had positive pelvic lymph nodes. Forty-six patients (79%) had invasion involving the outer 1/3 of the cervical stroma, six had positive vaginal margins while five had occult parametrial extension. After retrospective review of the histopathologic data from this case series, criteria from two recently published prospective multicenter Gynecologic Oncology Group (GOG) trials were applied to this data set. According to criteria established by GOG protocol 92, 30 (52%) patients should have theoretically received adjuvant pelvic radiation while 21 (36%) would have qualified for adjuvant chemotherapy and radiation according to the results of GOG protocol 109. In actual fact, only 35 patients (60%) received adjuvant radiotherapy and one received adjuvant chemo-radiation. Severe toxicity was unusual with two developing urinary fistulae and one having a pulmonary embolism. Despite the lack of adjuvant therapy in most cases, only 21 women (38%) recurred of whom 11 failed on the pelvic wall, with an estimated 5-year survival of 62.1%. CONCLUSIONS:Radical hysterectomy and tailored adjuvant radiation therapy in stage IB2 cervical cancer is feasible. Even without the liberal use of adjuvant therapy, survival in this high-risk group compares favorably to primary chemotherapy and radiation. According to recently published randomized clinical trials, most patients should receive adjuvant postoperative therapy. The benefits of this multimodality approach require randomized study.


Gynecol Oncol


Gynecologic oncology


Yessaian A,Magistris A,Burger RA,Monk BJ




Has Abstract


2004-07-01 00:00:00














  • Multicystic benign mesothelioma of the peritoneum presenting as postmenopausal bleeding and a solitary pelvic cyst--a case report.

    abstract:BACKGROUND:All non-invasive diagnostic algorithms suffer from diagnostic uncertainty in discriminating benign from malignant adnexal masses. CASE:We present a case where the identification of a large solitary multiloculated pelvic cyst in a woman with postmenopausal bleeding was shown to be multifocal multicystic beni...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Varma R,Wallace R

    更新日期:2004-01-01 00:00:00

  • High risk malignant gestational trophoblastic disease: experience with triple chemotherapy (MAC) in Third World circumstances.

    abstract::Fifty-seven patients with malignant gestational trophoblastic disease (GTD) were treated by the Gynecologic Oncology Unit of the Tygerberg Hospital, Parowvallei, RSA, between 1977 and 1986. Treatment was primarily with triple chemotherapy (MAC) followed by citrovorum factor. The total remission rate in the 23 patients...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: du Toit JP

    更新日期:1989-03-01 00:00:00

  • TP53 hot spot mutations in ovarian cancer: selective resistance to microtubule stabilizers in vitro and differential survival outcomes from The Cancer Genome Atlas.

    abstract:OBJECTIVE:To test if TP53 hot spot mutations (HSMs) confer differential chemotherapy resistance or survival outcomes, the effects of microtubule stabilizers on human ovarian carcinoma cells (OCCs) expressing TP53 HSMs were studied in vitro. Survival outcomes of patients with high grade serous epithelial ovarian carcino...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Seagle BL,Yang CP,Eng KH,Dandapani M,Odunsi-Akanji O,Goldberg GL,Odunsi K,Horwitz SB,Shahabi S

    更新日期:2015-07-01 00:00:00

  • Relationships between c-Ki-ras mutations, HPV types, and prognostic indicators in invasive endocervical adenocarcinomas.

    abstract:OBJECTIVE:Ras gene mutations have been identified in squamous cell carcinomas of the cervix and are associated with advanced-stage tumors. The current study was designed to determine the prevalence of c-Ki-ras mutations in invasive endocervical adenocarcinomas and associations between mutations, HPV status, and known p...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Koulos JP,Wright TC,Mitchell MF,Silva E,Atkinson EN,Richart RM

    更新日期:1993-03-01 00:00:00

  • A phase II trial of high-dose mitoxantrone, carboplatin, and cyclophosphamide with autologous bone marrow rescue for recurrent epithelial ovarian carcinoma: analysis of risk factors for clinical outcome.

    abstract::Despite high initial response rates to platinum-based chemotherapy, most patients with advanced ovarian carcinoma die of drug-resistant disease. Drug resistance can be overcome in the hematologic malignancies and lymphomas with high-dose therapy and bone marrow transplantation (BMT) when used early, suggesting that th...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Stiff P,Bayer R,Camarda M,Tan S,Dolan J,Potkul R,Loutfi S,Kinch L,Sosman J,Peace D

    更新日期:1995-06-01 00:00:00

  • Abnormal cervical cytology leading to the diagnosis of gastric cancer.

    abstract::There have been nine cases reported in the English literature in which the finding of malignant cells on cervical/vaginal cytology led to the diagnosis of primary gastric cancer. We report on a patient with gastric carcinoma, metastatic to the cervix, in which the diagnosis was suspected by the finding of signet ring ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: McGill F,Adachi A,Karimi N,Wadler S,Kim ES,Greston WM,Kleiner GJ

    更新日期:1990-01-01 00:00:00

  • Outcome of investigations for postmenopausal vaginal bleeding in women under the age of 50 years.

    abstract:OBJECTIVE:The objective of this study is to determine the incidence of endometrial cancer in young postmenopausal women presenting with vaginal bleeding. METHODS:Cross-sectional study of postmenopausal women presenting with vaginal bleeding in a gynaecological oncology centre in the United Kingdom. All women underwent...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Burbos N,Musonda P,Crocker SG,Morris EP,Duncan TJ,Nieto JJ

    更新日期:2012-04-01 00:00:00

  • Management of cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia: lessons from the field.

    abstract:OBJECTIVE:We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia. METHODS:We established criteria for patient referral, developed a training program for loop elect...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Pfaendler KS,Mwanahamuntu MH,Sahasrabuddhe VV,Mudenda V,Stringer JS,Parham GP

    更新日期:2008-09-01 00:00:00

  • Ascites, pleural effusion, and CA 125 elevation in an SLE patient, either a Tjalma syndrome or, due to the migrated Filshie clips, a pseudo-Meigs syndrome.

    abstract:BACKGROUND:The combination ascites, pleural effusion, and elevated CA 125 are usually associated with a malignancy. CASE:A 38-year-old SLE patient consulted her physician for shortness of breath. On clinical examination, she had a tender abdomen and reduced breathing sounds. X-ray and computed tomography of the chest ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Tjalma WA

    更新日期:2005-04-01 00:00:00

  • Strategies in late stage cervix carcinoma.

    abstract::Stage IIB-IV squamous cell carcinoma of the cervix when treated by irradiation has a significant failure rate. Causes of pelvic and distant failure are discussed. New techniques employed to improve local control and decrease distant metastasis are presented. Data on morbidity, mortality, and survival will be reviewed ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Krochak R

    更新日期:1986-03-01 00:00:00

  • Characterization of the protein synthesis independent TNFalpha lytic mechanism in human ovarian and cervical carcinoma cell lines.

    abstract::The analysis of the lytic mechanism initiated by TNFalpha in three human ovarian cell lines (CAOV-3, SK-OV-3, and OVCAR-3) and in three human cervical cell lines (SIHa, HT-3, and ME-180) in the presence of inhibitors of protein synthesis indicates that this lytic mechanism is similar to the protein synthesis-independe...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Powell CB,Scott JH,Collins JL

    更新日期:1996-07-01 00:00:00

  • Gynecologic oncology providers endorse practice-changing impact of communication skills training.

    abstract:OBJECTIVE:Effective communication improves patient outcomes and is crucial to good patient care. Communication skills training (CST) has been shown to improve communication skills in non-gynecologic oncology specialties. We sought to develop and test CST for gynecologic oncology (GO) providers. METHODS:We developed an...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Lefkowits C,Bevis K,Carey EC,Sheeder J,Arnold RM,Podgurski L

    更新日期:2019-06-01 00:00:00

  • Disparities in hospice care among older women dying with ovarian cancer.

    abstract:BACKGROUND:Timely hospice referral is an essential component of quality end-of-life care, although a growing body of research suggests that for patients with various types of cancer, hospice referrals often occur very late in the course of care, and are marked by sociodemographic disparities. However, little is known a...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Fairfield KM,Murray KM,Wierman HR,Han PK,Hallen S,Miesfeldt S,Trimble EL,Warren JL,Earle CC

    更新日期:2012-04-01 00:00:00

  • Beyond prophylaxis: Extended risk of venous thromboembolism following primary debulking surgery for ovarian cancer.

    abstract:OBJECTIVE:To determine the incidence and risk factors for venous thromboembolism (VTE) within six months after primary debulking surgery (PDS) for epithelial ovarian cancer (EOC). METHODS:In a historical cohort, we estimated the cumulative incidence of clinically diagnosed VTE within 6 months among consecutive women w...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Wagner BE,Langstraat CL,McGree ME,Weaver AL,Sarangi S,Mokri B,Dowdy SC,Cliby WA,Kumar A,Bakkum-Gamez JN

    更新日期:2019-02-01 00:00:00

  • Involvement of the spleen in ovarian adenosquamous carcinoma.

    abstract::Classification of ovarian tumors according to FIGO does not take into account involvement of spleen. A patient who appears to be the first reported case of widespread carcinoma of the ovary with involvement of the splenic parenchyma is presented. ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Glezerman M,Yanai-Inbar I,Charuzi I,Katz M,Glasner M,Piura B

    更新日期:1988-05-01 00:00:00

  • Mesodermal mixed tumor primary in the fallopian tube.

    abstract::Mullerian mixed tumors, as a group, are uncommon. Only 27 cases of this tumor of the fallopian tube have been reported to date. We report the 28th case of mixed mesodermal tumor, originating in the fallopian tube. A 79-year-old woman had mistaken a bloody vaginal discharge for hematuria. Various examinations showed no...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Kinoshita M,Asano S,Yamashita M,Matsuda T

    更新日期:1989-03-01 00:00:00

  • Bleomycin sclerotherapy of an intractable inguinal lymphocyst.

    abstract::One of the complications of an inguinal lymphadenectomy is formation of a lymphocyst. The literature dealing with management of this complication is scant. In this report we present a patient who developed an inguinal lymphocyst which did not respond to percutaneous drainage, but was successfully treated with scleroth...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Khorram O,Stern JL

    更新日期:1993-08-01 00:00:00

  • Loop electrocautery excisional procedure: therapeutic effectiveness as an ablation and a conization equivalent.

    abstract::This study was designed to compare the effectiveness of loop excision procedures as ablation and conization equivalents, and their use in recurrent cervical high-grade dysplasia patients. We retrospectively reviewed patients undergoing loop procedures between January 1992 and April 1994. Conization equivalents were de...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Gold M,Dunton CJ,Murray J,Macones G,Hanau C,Carlson JA Jr

    更新日期:1996-05-01 00:00:00

  • Suberoylanilide hydroxamic acid (SAHA) potentiates paclitaxel-induced apoptosis in ovarian cancer cell lines.

    abstract:OBJECTIVES:To determine if SAHA, a histone deacetylase inhibitor, decreases ovarian cancer cell viability when combined with paclitaxel in vitro, and to explore molecular alterations of combined paclitaxel+SAHA treatment. METHODS:SKOV3 and Hey ovarian cancer cell lines were treated for 24 h with paclitaxel, then re-tr...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Dietrich CS 3rd,Greenberg VL,DeSimone CP,Modesitt SC,van Nagell JR,Craven R,Zimmer SG

    更新日期:2010-01-01 00:00:00

  • Role of toll-like receptors in cervical, endometrial and ovarian cancers: a review.

    abstract:OBJECTIVE:The Toll-like receptors (TLRs) have been implicated in inflammation, innate immunity and cancer. The goal of this paper is to review the available published research about Toll-like receptors and their roles in gynecologic malignancies. METHODS:A Medline search was conducted and published articles from the l...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: Husseinzadeh N,Davenport SM

    更新日期:2014-11-01 00:00:00

  • Inverse correlation between RASSF1A hypermethylation, KRAS and BRAF mutations in cervical adenocarcinoma.

    abstract:OBJECTIVE:Although the incidence of cervical adenocarcinoma is increasing, few genetic and epigenetic changes in its progression have been described. We hypothesized that RASSF1A methylation and KRAS and BRAF mutations may play an important role in cervical adenocarcinoma. METHODS:Archival primary carcinoma tissues (n...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Kang S,Kim HS,Seo SS,Park SY,Sidransky D,Dong SM

    更新日期:2007-06-01 00:00:00

  • Cisplatin, adriamycin, etoposide, megestrol acetate versus melphalan, 5-fluorouracil, medroxyprogesterone acetate in the treatment of endometrial carcinoma.

    abstract::Fifty consecutive patients with documented advanced or recurrent endometrial carcinoma from 1978 through 1985 were prospectively treated with melphalan, 5-fluorouracil, medroxyprogesterone acetate (MFP) as first-line chemotherapy. From 1987 through 1993, 50 consecutive patients with documented advanced or recurrent en...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Cornelison TL,Baker TR,Piver MS,Driscoll DL

    更新日期:1995-11-01 00:00:00

  • Uterine sarcoma occurring in a premenopausal patient after uterine artery embolization: a case report and review of the literature.

    abstract:OBJECTIVE:We report a case of uterine leiomyosarcoma occurring after uterine artery embolization and review the previously published cases. We estimate the incidence of sarcoma after UAE, the mean diagnostic delay in young women undergoing this procedure and review the potential and limits of preoperative procedures in...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Papadia A,Salom EM,Fulcheri E,Ragni N

    更新日期:2007-01-01 00:00:00

  • Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study.

    abstract:OBJECTIVE:Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease....

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,多中心研究


    authors: Mangili G,Ottolina J,Cormio G,Loizzi V,De Iaco P,Pellegrini DA,Candiani M,Giorda G,Scarfone G,Cecere SC,Frigerio L,Gadducci A,Marchetti C,Ferrandina G

    更新日期:2016-11-01 00:00:00

  • Perineural invasion (PNI) in vulvar carcinoma: A review of 421 cases.

    abstract:OBJECTIVES:To evaluate the prevalence and associated prognostic indicators in patients with vulvar carcinoma with and without evidence of perineural invasion (PNI). METHODS:A retrospective review identified 421 patients with invasive vulvar carcinoma evaluated at a single institution between 1993 and 2011. Medical rec...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Salcedo MP,Sood AK,Dos Reis R,Ramalingam P,Chen C,Frumovitz M,Jhingran A,Pitcher B,Ramirez PT,Schmeler KM

    更新日期:2019-01-01 00:00:00

  • Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study.

    abstract:OBJECTIVE:To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS:Patients from the prospective observational multi-centre study "EMBRACE" were...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Knoth J,Pötter R,Jürgenliemk-Schulz IM,Haie-Meder C,Fokdal L,Sturdza A,Hoskin P,Mahantshetty U,Segedin B,Bruheim K,Wiebe E,Rai B,Cooper R,van der Steen-Banasik E,van Limbergen E,Pieters BR,Sundset M,Tan LT,Nout RA,T

    更新日期:2020-10-01 00:00:00

  • Paclitaxel and carboplatin in the adjuvant treatment of patients with high-risk stage III and IV endometrial cancer: a retrospective study.

    abstract:PURPOSE:To determine overall survival and progression-free survival among patients with high-risk, stage III and IV endometrial cancer who receive paclitaxel and carboplatin (TC) after complete tumor resection. PATIENTS AND METHODS:Patients with stage III/IV endometrial cancer with less than 2 cm of disease after surg...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Sovak MA,Hensley ML,Dupont J,Ishill N,Alektiar KM,Abu-Rustum N,Barakat R,Chi DS,Sabbatini P,Spriggs DR,Aghajanian C

    更新日期:2006-11-01 00:00:00

  • Vulvar intraepithelial neoplasia in women infected with human immunodeficiency virus-1.

    abstract::The purpose of this study was to determine the response of vulvar intraepithelial neoplasia (VIN) lesions to standard treatment methods in women infected with human immunodeficiency virus (HIV). We reviewed all cases of VIN over a 4-year period at an inner-city hospital. We reviewed the clinical records of these women...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Korn AP,Abercrombie PD,Foster A

    更新日期:1996-06-01 00:00:00

  • Role of hysterectomy in management of gestational trophoblastic disease.

    abstract:OBJECTIVE:To evaluate incidence, indications, and outcome of hysterectomy in women presenting with gestational trophoblastic disease. METHODS:A prospective observational study using a standardized protocol for registration, assessment, and treatment of gestational trophoblastic disease. A total of 5976 consecutive new...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Pisal N,North C,Tidy J,Hancock B

    更新日期:2002-11-01 00:00:00

  • Mesorectal lymph node involvement and prognostic implications at total pelvic exenteration for gynecologic malignancies.

    abstract:OBJECTIVES:To determine the incidence and prognostic implications of positive mesorectal lymph nodes in patients undergoing total pelvic exenteration for recurrent gynecologic malignancies. METHODS:We performed a retrospective chart review of all patients who had undergone total pelvic exenteration for a gynecologic m...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Mourton SM,Chi DS,Sonoda Y,Alektiar KM,Venkatraman ES,Barakat RR,Abu-Rustum NR

    更新日期:2006-03-01 00:00:00