Identifying a low-risk group for parametrial involvement in microscopic Stage IB1 cervical cancer using criteria from ongoing studies and a new MRI criterion

详细信息    查看全文

• 作者：Jung-Yun Lee (1)
  Jina Youm (2)
  Jae-Weon Kim (2)
  Jeong Yeon Cho (3)
  Min A Kim (4)
  Tae Hun Kim (5)
  Dong Hoon Suh (6)
  Myong Cheol Lim (7)
  Noh Hyun Park (2)
  Yong-Sang Song (2)
  
  1. Department of Obstetrics and Gynecology ; Institute of Women鈥檚 Medical Life Science ; Yonsei University College of Medicine ; 50-1 Yonsei-ro ; Seodaemun-gu ; 120-752 ; Seoul ; Korea
  2. Department of Obstetrics and Gynecology ; Seoul National University College of Medicine ; 101 Daehak-ro ; Jongno-gu ; 110-744 ; Seoul ; Korea
  3. Department of Radiology ; Seoul National University College of Medicine ; Seoul ; Korea
  4. Department of Pathology ; Seoul National University College of Medicine ; Seoul ; Korea
  5. Department of Obstetrics and Gynecology ; Korea Cancer Center ; Seoul ; Korea
  6. Department of Obstetrics and Gynecology ; Seoul National University Bundang Hospital ; Gyeonggi-di ; Korea
  7. Center for Uterine Cancer and Gynecologic Cancer Branch ; National Cancer Center ; Goyang ; Gyeonggi-do ; Korea
  
• 关键词：Cervical cancer ; Microscopic IB1 ; Parametrial involvement ; Less radical surgery ; Magnetic resonance imaging
• 刊名：BMC Cancer
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：334 KB
• 参考文献：1. Lee, JY, Kim, EY, Jung, KW, Shin, A, Chan, KK, Aoki, D (2014) Trends in gynecologic cancer mortality in East Asian regions. J Gynecol Oncol 25: pp. 174-82 CrossRef
  2. Lee, JY, Youm, J, Kim, TH, Cho, JY, Kim, MA, Suh, DH (2014) Preoperative MRI criteria for trials on less radical surgery in Stage IB1 cervical cancer. Gynecol Oncol 134: pp. 47-51 CrossRef
  3. Wright, JD, Grigsby, PW, Brooks, R, Powell, MA, Gibb, RK, Gao, F (2007) Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy. Cancer 110: pp. 1281-6 CrossRef
  4. Jung, DC, Kim, MK, Kang, S, Seo, SS, Cho, JY, Park, NH (2010) Identification of a patient group at low risk for parametrial invasion in early-stage cervical cancer. Gynecol Oncol 119: pp. 426-30 CrossRef
  5. Frumovitz, M, Sun, CC, Schmeler, KM, Deavers, MT, Reis, R, Levenback, CF (2009) Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer. Obstet Gynecol 114: pp. 93-9 CrossRef
  6. Gemer, O, Eitan, R, Gdalevich, M, Mamanov, A, Piura, B, Rabinovich, A (2013) Can parametrectomy be avoided in early cervical cancer? An algorithm for the identification of patients at low risk for parametrial involvement. Eur J Surg Oncol 39: pp. 76-80 CrossRef
  7. Kamimori, T, Sakamoto, K, Fujiwara, K, Umayahara, K, Sugiyama, Y, Utsugi, K (2011) Parametrial involvement in FIGO stage IB1 cervical carcinoma diagnostic impact of tumor diameter in preoperative magnetic resonance imaging. Int J Gynecol Cancer 21: pp. 349-54
  8. Park, JY, Lee, JW, Park, BK, Lee, YY, Choi, CH, Kim, TJ (2014) Postoperative outcomes of MR-invisible stage IB1 cervical cancer. Am J Obstet Gynecol 211: pp. 168.e1鈥? CrossRef
  9. Mikami, M, Aoki, Y, Sakamoto, M, Shimada, M, Takeshima, N, Fujiwara, H (2013) Current surgical principle for uterine cervical cancer of stages Ia2, Ib1, and IIa1 in Japan: a survey of the Japanese Gynecologic Oncology Group. Int J Gynecol Cancer 23: pp. 1655-60 CrossRef
  10. Ramirez, PT, Pareja, R, Rendon, GJ, Millan, C, Frumovitz, M, Schmeler, KM (2014) Management of low-risk early-stage cervical cancer: should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?. Gynecol Oncol 132: pp. 254-9 CrossRef
  11. M.D. Anderson Cancer Center. Conservative surgery for women with cervical cancer. http://clinicaltrials.gov/show/NCT01048853 NLM Identifier: NCT 01048853.
  12. Covens A. GOG Protocol 278. http://www.gcig.igcs.org/Spring2012/2012_june_cervix_cancer_committee.pdf.
  13. Plante M. The SHAPE trial. http://www.gcig.igcs.org/Spring2012/2012_june_shape_trial.pdf.
  14. Kasamatsu T. JCOG 1101. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000011321&language=E.
  15. Kim, MK, Kim, MA, Kim, JW, Chung, HH, Park, NH, Song, YS (2012) Loop electrosurgical excision procedure findings for identification of patients with early-stage cervical cancer suitable for less radical surgery. Int J Gynecol Cancer 22: pp. 1214-9 CrossRef
  16. Biliatis, I, Kucukmetin, A, Patel, A, Ratnavelu, N, Cross, P, Chattopadhyay, S (2012) Small volume stage 1B1 cervical cancer: Is radical surgery still necessary?. Gynecol Oncol 126: pp. 73-7 CrossRef
  17. Maneo, A, Sideri, M, Scambia, G, Boveri, S, Dell'anna, T, Villa, M (2011) Simple conization and lymphadenectomy for the conservative treatment of stage IB1 cervical cancer, An Italian experience. Gynecol Oncol 123: pp. 557-60 CrossRef
  18. Pluta, M, Rob, L, Charvat, M, Chmel, R, Halaska, M, Skapa, P (2009) Less radical surgery than radical hysterectomy in early stage cervical cancer: a pilot study. Gynecol Oncol 113: pp. 181-4 CrossRef
  19. Rob, L, Pluta, M, Strnad, P, Hrehorcak, M, Chmel, R, Skapa, P (2008) A less radical treatment option to the fertility-sparing radical trachelectomy in patients with stage I cervical cancer. Gynecol Oncol 111: pp. S116-20 CrossRef
  20. Kokka, F, Bryant, A, Brockbank, E, Jeyarajah, A (2014) Surgical treatment of stage IA2 cervical cancer. Cochrane Database Syst Rev 5:
  21. Lakhman, Y, Akin, O, Park, KJ, Sarasohn, DM, Zheng, J, Goldman, DA (2013) Stage IB1 cervical cancer: role of preoperative MR imaging in selection of patients for fertility-sparing radical trachelectomy. Radiology 269: pp. 149-58 CrossRef
  
• 刊物主题：Cancer Research; Oncology; Stem Cells; Animal Models; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2407

文摘

Background There are currently three ongoing studies on less radical surgery in cervical cancer: ConCerv, GOG-278, and SHAPE. The aim of this study was to evaluate the performance of the criteria used in ongoing studies retrospectively and suggest a new, simplified criterion in microscopic Stage IB1 cervical cancer. Methods A retrospective analysis was performed in 125 Stage IB1 cervical cancer patients who had no clinically visible lesions and were allotted based on microscopic findings after conization. All patients had magnetic resonance imaging (MRI) after conization and underwent type C2 radical hysterectomy. We suggested an MRI criterion for less radical surgery candidates as patients who had no demonstrable lesions on MRI. The rates of parametrial involvement (PMI) were estimated for patients that satisfied the inclusion criteria for ongoing studies and the MRI criterion. Results The rate of pathologic PMI was 5.6% (7/125) in the study population. ConCerv and GOG-278 identified 11 (8.8%) and 14 (11.2%) patients, respectively, as less radical surgery candidates, and there were no false negative cases. SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria. Of these 67 patients, only one had pathologic PMI with tumor emboli. Conclusions This study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.