Is Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?
Conclusion In patients with LACC, hysterectomy is an option in the presence of a central residual tumor after CRT. However, the risk of grades 3 and 4 complications of performed surgery is high. The presence of macroscopic tumor in the pathology specimen and positive surgical margins are poor prognostic factors. The goal of the surgeon should be to achieve a negative surgical margin. It does not seem important if the surgery is simple or radical.
CONCLUSIONS: Due to high severe toxicity, RCT and IGABT with dose escalation followed by completion hysterectomy don't seem compatible. No benefit and increased severe late morbidity were observed. Combined intracavitary/interstitial technique is mandatory in large target volume at brachytherapy. PMID: 31864683 [PubMed - as supplied by publisher]
Conclusion: The addition of BB to standard CRT improved OS for women with cervical cancer and a positive margin after hysterectomy. No consistent survival benefit was seen to EBRT dose-escalation beyond 5040 cGy.
Authors: Zhao Z, Tang X, Mao Z, Zhao H Abstract High-dose-rate brachytherapy for cervical cancer after subtotal hysterectomy using standardized applicators cannot achieve a good absorbed-dose coverage of the target volume in special tumor morphologies and topographies due to the steep dose gradient. The aim of this pictorial essay is to present an individualized cylindrical vaginal applicator with oblique guide holes using 3D modeling and printing technologies used at the China-Japan Union Hospital of Jilin University for cervical cancer patients. We use images to describe the steps of this method. PMID: 31749858 [PubMed]
In conclusion, HDR-BT was an effective treatment modality for patients with cervical cancer recurrence in the vaginal stump. PMID: 31579327 [PubMed - in process]
Conclusion: Concurrent chemo-radiotherapy appears to be an effective regimen, with acceptable toxicity, for patients with locally advanced cervical cancer. PMID: 31281416 [PubMed]
This study evaluated whether racial disparities in the receipt of brachytherapy (BT) for locally advanced cervical cancer mediate survival differences by race using the National Cancer Database. METHODS: A retrospective cohort study was performed using 16,116 women with stage IB2-IVA cervical cancer treated from 2004 to 2014. Women who did not receive external beam radiation therapy, those with unknown survival data or stage, and those status post hysterectomy or pelvic exenteration were excluded. Multivariate logistic regression was performed to evaluate factors associated with BT use. Using a propensity score adjust...
ConclusionsNeoadjuvant chemoradiation therapy effectively downstages the majority of locally advanced type II endometrial cancers, thereby increasing the likelihood of achieving complete resection with negative margins.
ConclusionsNeoadjuvant chemoradiotherapy effectively downstages the majority of locally-advanced type II endometrial cancers, thereby increasing the likelihood of achieving complete resection with negative margins.
Authors: Koper K, Dziobek K, Makarewicz R, Terlikiewicz J, Dutsch-Wicherek M Abstract Purpose: Locally advanced cervical cancer (LACC) should be treated with a combination of external irradiation and brachytherapy with concurrent chemotherapy. However, as cervical carcinoma cells can disperse by way of the lymphatic system to either pelvic or para-aortic nodes, planning the extent of radiation requires precise information about the spread of the disease to the lymph nodes, especially to the para-aortic area. Material and methods: All of the 75 women included in our study underwent chemoradiotherapy, which start...
This study evaluates a novel technique of laparoscopic ovarian transposition performed by Gynecologic Oncologists prior to pelvic radiation for gynecologic cancer. A retrospective review was completed of all patients that underwent laparoscopic ovarian transposition from February 2007 to June 2017 at one tertiary care cancer. The technique involves salpingectomy, followed by retroperitoneal dissection to move the ovaries lateral to the hepatic and splenic flexures of the colon. Normal ovarian function was defined by the absence of vasomotor symptoms, FSH and menstrual history (if menstruating). The radiation dose to the ov...