Tomoyasu Kato1, Atsuo Takashima2, Takahiro Kasamatsu3, Kenichi Nakamura2, Junki Mizusawa2, Toru Nakanishi4, Nobuhiro Takeshima5, Shoji Kamiura6, Takashi Onda7, Toshiyuki Sumi8, Masashi Takano9, Hidekatsu Nakai10, Toshiaki Saito11, Kiyoshi Fujiwara12, Masatoshi Yokoyama13, Hiroaki Itamochi14, Kazuhiro Takehara15, Harushige Yokota16, Tomoya Mizunoe17, Satoru Takeda18, Kenzo Sonoda19, Tanri Shiozawa20, Takayo Kawabata21, Shigeru Honma22, Haruhiko Fukuda2, Nobuo Yaegashi23, Hiroyuki Yoshikawa24, Ikuo Konishi25, Toshiharu Kamura26. 1. Department of Gynecologic Oncology, National Cancer Center Hospital, Japan. Electronic address: tokato@ncc.go.jp. 2. Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan. 3. Department of Gynecologic Oncology, National Cancer Center Hospital, Japan. 4. Department of Gynecologic Oncology, Aichi Cancer Center, Japan. 5. Department of Gynecology, Cancer Institute Hospital, Japan. 6. Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan. 7. Department of Obstetrics and Gynecology, Kitasato University, Japan. 8. Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Japan. 9. Department of Obstetrics and Gynecology, National Defense Medical College, Japan. 10. Department of Gynecology, Kinki University, Japan. 11. Gynecologic Service, National Kyushu Cancer Center, Japan. 12. Department of Gynecologic Oncology, Hyogo Cancer Center, Japan. 13. Department of Gynecology and Obstetrics, Saga University, Japan. 14. Department of Obstetrics and Gynecology, Tottori University, Japan. 15. Department of Gynecologic Oncology, Shikoku Cancer Center, Japan. 16. Department of Gynecologic Oncology, Saitama Cancer Center, Japan. 17. Department of Gynecologic Oncology, Kure Medical Center, Japan. 18. Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Japan. 19. Department of Obstetrics and Gynecology, Kyushu University, Japan. 20. Department of Obstetrics and Gynecology, Shinshu University, Japan. 21. Department of Obstetrics and Gynecology, Kagoshima City Hospital, Japan. 22. Department of Gynecology, Niigata Cancer Center Hospital, Japan. 23. Department of Obstetrics and Gynecology, Tohoku University, Japan. 24. Department of Obstetrics and Gynecology, University of Tsukuba, Japan. 25. Department of Gynecology and Obstetrics, Kyoto University, Japan. 26. Department of Obstetrics and Gynecology, Kurume University, Japan.
Abstract
OBJECTIVE: In order to determine indications for less radical surgery such as modified radical hysterectomy, the risk of pathological parametrial involvement and prognosis of FIGO stage IB1 cervical cancer patients undergoing standard radical hysterectomy with pre-operatively assessed tumor diameter≤2 cm were investigated. METHODS: We conducted a retrospective multi-institutional chart review of patients with FIGO stage IB1 cervical cancer who underwent primary surgical treatment between 1998 and 2002. The eligibility criteria for the analyses were (i) histologically-proven squamous cell carcinoma, adenocarcinoma or, adenosquamous cell carcinoma, (ii) radical hysterectomy performed, (iii) clinical tumor diameter data available by MR imaging or specimens by cone biopsy, and (iv) age between 20 and 70. Based on the clinical tumor diameter, patients were stratified into those with the following tumors: i) 2 cm or less (cT≤2 cm) and ii) greater than 2 cm (cT>2 cm). We expected 5-year OS of ≥95% and parametrial involvement<2-3% for patients with cT≤2 cm who underwent radical hysterectomy. RESULTS: Of the 1269 patients enrolled, 604 were eligible for the planned analyses. Among these, 571 underwent radical hysterectomy (323 with cT≤2 cm and 248 with cT>2 cm). Parametrial involvement was present in 1.9% (6/323) with cT≤2 cm and 12.9% (32/248) with cT>2 cm. Five-year overall survivals were 95.8% (95% CI 92.9-97.6%) in cT≤2 cm and 91.9% (95% CI 87.6-94.8%) in cT>2 cm patients. CONCLUSION: Patients with cT≤2 cm had lower risk of parametrial involvement and more favorable 5-year overall survival. They could therefore be good candidates for receiving less radical surgery.
OBJECTIVE: In order to determine indications for less radical surgery such as modified radical hysterectomy, the risk of pathological parametrial involvement and prognosis of FIGO stage IB1 cervical cancerpatients undergoing standard radical hysterectomy with pre-operatively assessed tumor diameter≤2 cm were investigated. METHODS: We conducted a retrospective multi-institutional chart review of patients with FIGO stage IB1 cervical cancer who underwent primary surgical treatment between 1998 and 2002. The eligibility criteria for the analyses were (i) histologically-proven squamous cell carcinoma, adenocarcinoma or, adenosquamous cell carcinoma, (ii) radical hysterectomy performed, (iii) clinical tumor diameter data available by MR imaging or specimens by cone biopsy, and (iv) age between 20 and 70. Based on the clinical tumor diameter, patients were stratified into those with the following tumors: i) 2 cm or less (cT≤2 cm) and ii) greater than 2 cm (cT>2 cm). We expected 5-year OS of ≥95% and parametrial involvement<2-3% for patients with cT≤2 cm who underwent radical hysterectomy. RESULTS: Of the 1269 patients enrolled, 604 were eligible for the planned analyses. Among these, 571 underwent radical hysterectomy (323 with cT≤2 cm and 248 with cT>2 cm). Parametrial involvement was present in 1.9% (6/323) with cT≤2 cm and 12.9% (32/248) with cT>2 cm. Five-year overall survivals were 95.8% (95% CI 92.9-97.6%) in cT≤2 cm and 91.9% (95% CI 87.6-94.8%) in cT>2 cm patients. CONCLUSION:Patients with cT≤2 cm had lower risk of parametrial involvement and more favorable 5-year overall survival. They could therefore be good candidates for receiving less radical surgery.
Authors: Hiroko Machida; Rachel S Mandelbaum; Mikio Mikami; Takayuki Enomoto; Yukio Sonoda; Brendan H Grubbs; Richard J Paulson; Lynda D Roman; Jason D Wright; Koji Matsuo Journal: Am J Obstet Gynecol Date: 2018-08-21 Impact factor: 8.661
Authors: Jill H Tseng; Alessia Aloisi; Yukio Sonoda; Ginger J Gardner; Oliver Zivanovic; Nadeem R Abu-Rustum; Mario M Leitao Journal: Int J Gynecol Cancer Date: 2018-09 Impact factor: 3.437
Authors: Yan Yan Yu; Rui Zhang; Rui Tong Dong; Qi Yun Hu; Tao Yu; Fan Liu; Ya Hong Luo; Yue Dong Journal: Br J Radiol Date: 2019-04-01 Impact factor: 3.039