Database : MEDLINE
Search on : uterine and cervical and neoplasms [Words]
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[PMID]: 29523141
[Au] Autor:Kim JH; Kim DY; Suh DS; Kim JH; Kim YM; Kim YT; Nam JH
[Ad] Address:Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
[Ti] Title:The efficacy of sentinel lymph node mapping with indocyanine green in cervical cancer.
[So] Source:World J Surg Oncol;16(1):52, 2018 Mar 09.
[Is] ISSN:1477-7819
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Lymph node metastasis is a significant predictive factor for disease recurrence and survival in cervical cancer patients. Given the importance of lymph node metastasis, it is imperative that patients harboring metastasis are identified and can undergo appropriate treatment. Sentinel lymph node (SLN) mapping has drawn attention as a lymph node mapping technique. We evaluated the feasibility and efficacy of (SLN) mapping using indocyanine green (ICG) in cervical cancer. METHODS: We performed a single-center, retrospective study of 103 surgically treated cervical cancer patients who underwent SLN mapping. After using ICG to detect SLN during surgery, we removed the SLNs followed by laparoscopic or robotic-assisted radical surgery and bilateral pelvic lymphadenectomy. RESULTS: Stage IB1 was the most common (61.17%). At least one SLN was detected in all cases. Eighty-eight patients (85.44%) had bilateral pelvic SLNs. The mean number of SLN per patient was 2.34. The side-specific sensitivity was 71.43%, the specificity was 100%, the negative predictive value (NPV) was 93.98%, and the false negative rate (FNR) was 28.57%. In cases of tumors smaller than 2 cm with negative lymph node metastasis on imaging, the study revealed a side-specific sensitivity of 100%, a specificity of 100%, a NPV of 100%, and a FNR of 0%. Large tumor size (≥ 4 cm), a previous history of a loop electrosurgical excision procedure (LEEP), depth of invasion (≥ 50%), the microscopic parametrial (PM) invasion, and vaginal extension were significantly associated with the false-negative detection of SLN. Moreover, the microscopic PM invasion was the only risk factor of the false-negative detection of SLN in multivariate analysis. CONCLUSION: SLN mapping with ICG in cervical cancer is feasible and has high detection rate. The sensitivity of 100% was high enough to perform SLN biopsy alone in an early stage in which the tumor is less than 2 cm, with no lymphadenopathy on image examination. However, for large or invasive tumors, we would have to be cautious about performing SLN biopsy alone. TRIAL REGISTRATION: Retrospectively registered 2017-0600.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process
[do] DOI:10.1186/s12957-018-1341-6

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[PMID]: 29505548
[Au] Autor:Xu M; Zhou F; Huang L
[Ad] Address:Department of Pathology.
[Ti] Title:Concomitant endometrial and cervical adenocarcinoma: A case report and literature review.
[So] Source:Medicine (Baltimore);97(1):e9596, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Concomitant malignancy of the endometrium and cervix is extremely rare. PATIENT CONCERNS: A 56-year-old female presented to the Women's Hospital, School of Medicine, Zhejiang University, complaining of irregular vaginal bleeding. The human papillomavirus test (type 18/45) was positive. We performed dilation and curettage; pathology revealed moderately differentiated endometrial carcinoma exhibiting squamous differentiation. The epithelium of the cervical uterus was atypical upon biopsy. DIAGNOSES: Histological and immunochemical tests confirmed a diagnosis of endometrial carcinoma concomitant with cervical adenocarcinoma. INTERVENTIONS: She underwent laparoscopic staging surgery. OUTCOMES: The patient fully recovered with only surgery. LESSONS: Endometrial carcinoma concomitant with cervical adenocarcinoma is very rare. It is imperative to schedule adequate examination, and to perform careful preoperative diagnosis and appropriate treatment to minimize relapse.
[Mh] MeSH terms primary: Adenocarcinoma/pathology
Endometrial Neoplasms/pathology
Neoplasms, Multiple Primary/pathology
Uterine Cervical Neoplasms/pathology
Uterus/pathology
[Mh] MeSH terms secundary: Female
Humans
Middle Aged
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009596

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[PMID]: 29505536
[Au] Autor:Founta C; Papagiannakis E; Ratnavelu N; Feusi A; Natsis S; Bradbury M; Fisher A; Naik R
[Ad] Address:Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital Gateshead, Gateshead.
[Ti] Title:Diagnostic accuracy of colposcopy with dynamic spectral imaging for cytology-negative/high-risk HPV positive (failed test of cure) after large loop excision of the transformation zone (LLETZ) of the cervix: Results of the DySIS colposcopy 1 study.
[So] Source:Medicine (Baltimore);97(1):e9560, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:After treatment for cervical intraepithelial neoplasia (CIN), in the UK women who are cytology-negative, high-risk (HR) human papilloma virus (HPV) positive are referred to colposcopy. This pilot study assessed the incidence of residual/recurrent CIN and the diagnostic accuracy of colposcopy with dynamic spectral imaging (DSI) mapping in their detection.This was a prospective service evaluation carried out in a UK National Health Service (NHS) colposcopy clinic. All women, referred with negative cytology/HR-HPV positive result following treatment for CIN from March 2013 until November 2014, who were examined with the DSI digital colposcope were included. We excluded 3 cases because of poor-quality imaging from user errors. Everyday clinical practice was followed. Initial colposcopic impression, DSI map indication, and biopsy site selections were recorded. CIN2+ was considered the primary outcome and CIN of any grade a secondary outcome.A total of 105 women were included of which 5 (4.8%) had CIN2+ histology and 24 (22.9%) had CIN1. Pre-DSI map colposcopy suggested normal/low grade in all 5 of the CIN2+ cases and DSI suggested high-grade (HG) CIN in 4 of the 5 cases. Sensitivity of standard colposcopy for CIN2+ was 0%, improving to 80% with the incorporation of the DSI map.The CIN burden in this population is higher than previously expected. Colposcopic identification of HG CIN appears to improve significantly with DSI in this cohort leading to refinement in patient management. A larger, multicentric prospective study (DySIS colposcopy 2) is planned to confirm these initial findings.
[Mh] MeSH terms primary: Cervical Intraepithelial Neoplasia/diagnosis
Colposcopy/statistics & numerical data
Neoplasm Recurrence, Local/diagnosis
Uterine Cervical Neoplasms/diagnosis
[Mh] MeSH terms secundary: Adult
Aged
Cervical Intraepithelial Neoplasia/surgery
Cervical Intraepithelial Neoplasia/virology
Colposcopy/methods
Female
Humans
Middle Aged
Neoplasm Recurrence, Local/virology
Papillomaviridae
Pilot Projects
Prospective Studies
Spectrum Analysis
Uterine Cervical Neoplasms/surgery
Uterine Cervical Neoplasms/virology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009560

  4 / 65180 MEDLINE  
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[PMID]: 29444073
[Au] Autor:Hall MT; Simms KT; Lew JB; Smith MA; Saville M; Canfell K
[Ad] Address:Cancer Research Division, Cancer Council NSW, Sydney, Australia.
[Ti] Title:Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.
[So] Source:PLoS One;13(2):e0185332, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017. METHODS: Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males). FINDINGS: Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates). However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives. CONCLUSIONS: Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses, resulting in longer term reductions in both cervical cancer incidence and mortality. Fluctuations in health outcomes due to the transition to a longer screening interval are predicted to occur for 10-15 years, but cervical cancer rates will be significantly reduced thereafter due to the impact of HPV vaccination and HPV screening. In order to maintain confidence in primary HPV screening through the transitional phase, it is important to widely communicate that an initial increase in CIN2/3 and perhaps even invasive cervical cancer is expected after a national transition to primary HPV screening, that this phenomenon is due to increased prevalent disease detection, and that this effect represents a marker of screening success.
[Mh] MeSH terms primary: Papillomavirus Infections/diagnosis
Papillomavirus Vaccines/administration & dosage
Uterine Cervical Neoplasms/epidemiology
[Mh] MeSH terms secundary: Australia/epidemiology
Female
Humans
Models, Biological
Papillomavirus Infections/prevention & control
Patient Compliance
Uterine Cervical Neoplasms/virology
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Papillomavirus Vaccines)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185332

  5 / 65180 MEDLINE  
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[PMID]: 28455170
[Au] Autor:D'Addario M; Redmond S; Scott P; Egli-Gany D; Riveros-Balta AX; Henao Restrepo AM; Low N
[Ad] Address:Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland.
[Ti] Title:Two-dose schedules for human papillomavirus vaccine: Systematic review and meta-analysis.
[So] Source:Vaccine;35(22):2892-2901, 2017 05 19.
[Is] ISSN:1873-2518
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Simpler schedules for human papillomavirus (HPV) vaccine delivery could improve vaccine coverage and the effectiveness of cervical cancer prevention. The objective of this study was to systematically review evidence about the effects of two-dose compared with three-dose schedules for human papillomavirus (HPV) vaccine and to describe the uptake of two-dose HPV vaccination schedules globally. We searched PubMed, the Cochrane Central Registry of Controlled Trials, trials registers, and manufacturers' databases from their earliest date to February 2016. We selected randomised controlled trials and controlled clinical trials that directly compared HPV vaccine schedules with two or three doses. We extracted data on immunological and clinical outcomes and used meta-analysis where appropriate. We also described the use of two-dose HPV vaccine schedules globally. We screened 1464 items and included seven eligible noninferiority trials in 11 countries. In randomised comparisons amongst adolescent girls (three trials), geometric mean concentrations (GMC) of antibodies against HPV16 and HPV18 were non-inferior or inconclusive, up to 24months after a two-dose compared with a three-dose schedule. One trial with a clinical outcome found no persistent HPV infections occurred after either two or three doses. In non-randomised comparisons, GMC were non-inferior or superior in adolescent girls receiving the two-dose schedule compared with women receiving the three-dose schedule for at least 21months after vaccination. By February 2017, 23 low and middle income and 25 high income countries had adopted a two-dose HPV vaccination schedule. A two-dose HPV vaccine schedule provides satisfactory immunological outcomes in adolescent girls, but uptake globally is limited, particularly in countries with the highest burden of cervical cancer.
[Mh] MeSH terms primary: Immunization Schedule
Papillomavirus Vaccines/administration & dosage
Papillomavirus Vaccines/immunology
[Mh] MeSH terms secundary: Adolescent
Adult
Antibodies, Viral/biosynthesis
Clinical Trials as Topic
Female
Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
Humans
Papillomaviridae/immunology
Papillomavirus Infections/prevention & control
Uterine Cervical Neoplasms/prevention & control
Vaccination
Vaccine Potency
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; META-ANALYSIS; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Antibodies, Viral); 0 (Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18); 0 (Papillomavirus Vaccines)
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[St] Status:MEDLINE

  6 / 65180 MEDLINE  
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[PMID]: 29400024
[Au] Autor:Choi YJ; Lee A; Kim TJ; Jin HT; Seo YB; Park JS; Lee SJ
[Ad] Address:Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
[Ti] Title:E2/E6 ratio and L1 immunoreactivity as biomarkers to determine HPV16-positive high-grade squamous intraepithelial lesions (CIN2 and 3) and cervical squamous cell carcinoma.
[So] Source:J Gynecol Oncol;, 2018 Feb 01.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Human papillomavirus (HPV) 16 is the most carcinogenic HPV genotype. We investigated if HPV16 L1 capsid protein and E2/E6 ratio, evaluated by cervical cytology, may be used as biomarkers of ≥cervical intraepithelial neoplasia (CIN) 2 lesions. METHODS: Cervical specimens were obtained from 226 patients with HPV16 single infection. Using cytology specimen, L1 capsid protein and E2/E6 ratio were detected and the results were compared with those of the conventional histologic analysis of cervical tissues (CIN1-3 and squamous cell carcinoma [SCC]) to evaluate the association. RESULTS: The L1 positivity of CIN2/3 was significantly lower than that of normal cervical tissue (p<0.001) and SCC demonstrated significantly lower L1 positivity than CIN1 (p<0.001). The mean E2/E6 ratios of specimens graded as SCC (0.356) and CIN2/3 (0.483) were significantly lower than those of specimens graded as CIN1 (0.786) and normal (0.793) (p<0.05). We observed that area under the receiver operating characteristic curve (AUC) for E2/E6 ratio (0.844; 95% confidence interval [CI]=0.793-0.895) was higher than that for L1 immunochemistry (0.636; 95% CI=0.562-0.711). A combination of E2/E6 ratio and L1 immunocytochemistry analyses showed the highest AUC (0.871; 95% CI=0.826-0.917) for the prediction of ≥CIN2 lesions. CONCLUSION: To our knowledge, this is the first study to validate HPV L1 capsid protein expression and decreased HPV E2/E6 ratio as valuable predictive markers of ≥CIN2 cervical lesions. Cervical cytology may be analyzed longitudinally on an outpatient basis with noninvasive procedures as against invasive conventional histologic analysis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.3802/jgo.2018.29.e38

  7 / 65180 MEDLINE  
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[PMID]: 29400017
[Au] Autor:Machida H; Blake EA; Eckhardt SE; Takiuchi T; Grubbs BH; Mikami M; Roman LD; Matsuo K
[Ad] Address:Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
[Ti] Title:Trends in single women with malignancy of the uterine cervix in United States.
[So] Source:J Gynecol Oncol;29(2):e24, 2018 Mar.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To examine trends and characteristics of single women with malignancy of the uterine cervix. METHODS: This is a retrospective observational study examining the United States population-based tumor registry (the Surveillance, Epidemiology, and End Results program). Time-specific trends in single marital status were examined in 3,294,208 women among 12 common female malignancies including 87,151 women with uterine cervical malignancy between 1973 and 2013. RESULTS: While the proportion of single women in the majority of malignancies increased during the study time, the proportion of single women with cervical malignancy significantly increased more than in other malignancies (29.3% in 2013 from 6.3% in 1973). There was a surge in the proportion of single women with cervical malignancy starting in the early 1990s, exhibiting the largest annual percentage rate change (APC) among all examined malignancies (1.8%; 95% confidence interval [CI]=1.6, 2.0; p<0.001). There was a significant decrease in the proportion of women aged <40 years with cervical malignancy between 1989 and 2013 (APC, -1.2%; 95% CI=-1.4, -1.0; p<0.001). However, when stratified by age, the proportion of single women aged ≥40 years increased significantly during the time (APC, 2.7%; 95% CI=2.3, 3.2; p<0.001) but did not in those who were <40 years (APC, 0.1%; 95% CI=-0.7, 0.6; p=0.850). CONCLUSION: The proportion of single women with malignancy of the uterine cervix has significantly increased in the past 4 decades. This increase was most dramatic in single women aged ≥40 years. Improving screening strategies in single women aged ≥40 years may help reduce the incidence of this malignancy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.3802/jgo.2018.29.e24

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[PMID]: 29400016
[Au] Autor:Mikami M; Shida M; Shibata T; Katabuchi H; Kigawa J; Aoki D; Yaegashi N
[Ad] Address:Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan. mmikami@is.icc.u-tokai.ac.jp.
[Ti] Title:Impact of institutional accreditation by the Japan Society of Gynecologic Oncology on the treatment and survival of women with cervical cancer.
[So] Source:J Gynecol Oncol;29(2):e23, 2018 Mar.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The Japan Society of Gynecologic Oncology (JSGO) initiated a nation-wide training system for the education and certification for gynecologic oncologists in 2005. To assess the impact of the quality of the JSGO-accredited institutions, JSGO undertook an analysis of the Uterine Cervical Cancer Registry of the Japan Society of Obstetrics and Gynecology (JSOG) to determine the effectiveness of the JSGO-accredited institutions on the treatment and survival of women with cervical cancer. METHODS: The effectiveness of 119 JSGO-accredited institutions and 125 non-JSGO-accredited institutions on the treatment and survival of women with cervical cancer were compared by analyzing the tumor characteristics, treatment patterns, and survival outcomes of women with stage T1B-T4 cervical cancer utilizing the data in the JSOG nation-wide registry for cervical cancer (2006-2009). RESULTS: A total of 14,185 eligible women were identified: 10,920 (77.0%) cases for 119 JSGO-accredited institutions and 3,265 (23.0%) cases for 125 non-accredited institutions. A multivariate analysis showed that age, stage, histology type, and treatment pattern were independently associated with mortality. Moreover, women who received treatment at the JSGO-accredited institutions had a significantly decreased mortality risk compared to non-accredited institutions (adjusted hazard ratio [aHR]=0.843; 95% confidence interval [CI]=0.784-0.905). Similar findings on multivariate analysis were seen among subset of women who received surgery alone (aHR=0.552; 95% CI=0.393-0.775) and among women who received radiotherapy (aHR=0.845; 95% CI=0.766-0.931). CONCLUSION: Successful implementation of gynecologic oncology accrediting institution was associated with improved survival outcome of women with cervical cancer in Japan.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.3802/jgo.2018.29.e23

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[PMID]: 29185263
[Au] Autor:Lee KB; Kim YS; Lee JM
[Ad] Address:Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
[Ti] Title:Oncologic outcomes of adjuvant chemotherapy alone after radical surgery for stage IB-IIA cervical cancer patients.
[So] Source:J Gynecol Oncol;29(1):e5, 2018 Jan.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate the oncologic outcomes of adjuvant chemotherapy (CT) alone after radical surgery. METHODS: We retrospectively reviewed the medical records of patients who underwent type C radical hysterectomy and pelvic lymphadenectomy with or without paraaortic lymphadenectomy for stage IB-IIA cervical cancer from March 2006 to December 2014 at 2 academic medical centers in Korea. Adjuvant CT alone for patients who met the Sedlis criteria or had lymph node (LN) involvement. Chemotherapeutic regimens consisted of either platinum alone or platinum-based combination. RESULTS: A total of 101 consecutive patients were included in the analysis. The median age was 46.0 years (range, 23-73). Seventy-four patients (73.3%) were clinically staged as IB1; 23 and 4 patients as IB2 and IIA, respectively. The median number of retrieved pelvic and paraaortic LNs (PALNs) were 55.0 (range, 16-101) and 10.0 (range, 2-30), respectively. LN involvement was observed in 25 patients (24.8%). After the median follow-up of 65 months, 14 patients (13.9%) developed disease recurrence. In all patients, the estimated 3-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were 90.7% and 90.6%, respectively. In patients who met the Sedlis criteria, the 3-year DFS and 5-year OS rates were 94.6% and 90.6%, respectively. Patients with LN metastasis showed a 3-year DFS rate of 79.4% and a 5-year OS rate of 90.6%. CONCLUSION: Adjuvant CT alone could be reasonable option for patients with surgical-pathologic risk factors after radical surgery in stage IB-IIA cervical cancer.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.3802/jgo.2018.29.e5

  10 / 65180 MEDLINE  
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[PMID]: 29185262
[Au] Autor:Jiang W; Xiang L; Pei X; He T; Shen X; Wu X; Yang H
[Ad] Address:Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.
[Ti] Title:Mutational analysis of KRAS and its clinical implications in cervical cancer patients.
[So] Source:J Gynecol Oncol;29(1):e4, 2018 Jan.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The predictive and prognostic role of KRAS mutations in cervical cancer remains inconclusive. The aim of this study was to explore the clinicopathological and prognostic relevance of KRAS mutations in invasive cervical cancers (ICC). METHODS: Reverse transcription polymerase chain reaction (PCR) and Sanger sequencing were employed to detect KRAS mutations in 876 ICC patients. Quantitative real-time PCR was used to detect human papillomavirus (HPV) 16 and HPV 18. RESULTS: Non-synonymous mutations of KRAS were identified in 30 (3.4%) patients. These mutations were more common in non-squamous cell carcinoma than in squamous cell carcinoma (SCC) (8.2% vs. 2.2%, respectively, p<0.001) and were associated with HPV 18 infection (p=0.003). The prevalence of mutations was highest (18.2%) in the uncommon histological subtypes followed by adenocarcinoma (AC, 7.3%) and adenosquamous carcinoma (ASC, 5.8%). During the median follow-up of 55 months, compared to patients with wild-type KRAS, a greater percentage of patients with mutant KRAS relapsed (20.0% vs. 42.9%, respectively, p=0.007). The 3-year relapse-free survival was poorer in patients with mutant KRAS than in patients without KRAS mutations (57.1% vs. 81.9%, respectively, p=0.001). Furthermore, the multivariate analysis showed that the presence of a KRAS mutation was an independent predictor for disease recurrence (hazard ratio [HR]=2.064; 95% confidence interval [CI]=1.125-3.787; p=0.019). CONCLUSION: KRAS mutations were predominant in non-SCCs of the cervix and were associated with HPV 18 infection. A combination of KRAS mutation detection and HPV genotyping would be useful in identifying patient with poor prognosis for further interventions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.3802/jgo.2018.29.e4


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