Xiaopei Chao1, Junning Fan2, Xiaochen Song1, Yan You3, Huanwen Wu3, Ming Wu1, Lei Li1. 1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China. 2. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. 3. Department of Pathology, Peking Union Medical College Hospital, Beijing, China.
Abstract
OBJECTIVE: The effectiveness of various strategies for the post-treatment monitoring of cervical cancer is unclear. This pilot study was conducted to explore recurrence patterns in and diagnostic strategies for patients with uterine cervical cancer who were meticulously followed using a customized monitoring plan. METHODS: The epidemiological and clinical data of patients with recurrent cervical cancer treated from March 2012 to April 2018 at a tertiary teaching hospital were retrospectively collected. The diagnostic methods and their reliability were compared across patients with various clinicopathological characteristics and were associated with survival outcomes. RESULTS: Two hundred sixty-four patients with recurrent cervical cancer were included in the study, among which recurrence occurred in the first three years after the last primary treatment in 214 patients (81.06%). Half of the recurrence events (50.76%) occurred only within the pelvic cavity, and most lesions (78.41%) were multiple in nature. Among all recurrent cases, approximately half were diagnosed based on clinical manifestations (n=117, 44.32%), followed by imaging examinations (n=76, 28.79%), serum tumor markers (n=34, 12.88%), physical examinations (n=33, 12.50%) and cervical cytology with or without high-risk human papillomavirus (hrHPV) testing (n=4, 1.52%). The reliability of the diagnostic methods was affected by the stage (p<0.001), primary treatment regimen (p=0.001), disease-free survival (p=0.022), recurrence site (p=0.002) and number of recurrence sites (p=0.001). Primary imaging methods (sonography and chest X-ray) were not inferior to secondary imaging methods (computed tomography, magnetic resonance imaging and positron emission tomography-computed tomography) in the detection of recurrence. The chest X-ray examination only detected three cases (1.14%) of recurrence. Patients assessed with various diagnostic strategies had similar progression-free and overall survival outcomes. CONCLUSIONS: A meticulous evaluation of clinical manifestations might allow recurrence to be discovered in a timely manner in most patients with cervical cancer. Specific diagnostic methods for revealing recurrence were not associated with the survival outcomes.
OBJECTIVE: The effectiveness of various strategies for the post-treatment monitoring of cervical cancer is unclear. This pilot study was conducted to explore recurrence patterns in and diagnostic strategies for patients with uterine cervical cancer who were meticulously followed using a customized monitoring plan. METHODS: The epidemiological and clinical data of patients with recurrent cervical cancer treated from March 2012 to April 2018 at a tertiary teaching hospital were retrospectively collected. The diagnostic methods and their reliability were compared across patients with various clinicopathological characteristics and were associated with survival outcomes. RESULTS: Two hundred sixty-four patients with recurrent cervical cancer were included in the study, among which recurrence occurred in the first three years after the last primary treatment in 214 patients (81.06%). Half of the recurrence events (50.76%) occurred only within the pelvic cavity, and most lesions (78.41%) were multiple in nature. Among all recurrent cases, approximately half were diagnosed based on clinical manifestations (n=117, 44.32%), followed by imaging examinations (n=76, 28.79%), serum tumor markers (n=34, 12.88%), physical examinations (n=33, 12.50%) and cervical cytology with or without high-risk human papillomavirus (hrHPV) testing (n=4, 1.52%). The reliability of the diagnostic methods was affected by the stage (p<0.001), primary treatment regimen (p=0.001), disease-free survival (p=0.022), recurrence site (p=0.002) and number of recurrence sites (p=0.001). Primary imaging methods (sonography and chest X-ray) were not inferior to secondary imaging methods (computed tomography, magnetic resonance imaging and positron emission tomography-computed tomography) in the detection of recurrence. The chest X-ray examination only detected three cases (1.14%) of recurrence. Patients assessed with various diagnostic strategies had similar progression-free and overall survival outcomes. CONCLUSIONS: A meticulous evaluation of clinical manifestations might allow recurrence to be discovered in a timely manner in most patients with cervical cancer. Specific diagnostic methods for revealing recurrence were not associated with the survival outcomes.
Authors: A Gadducci; S Cosio; F Landoni; T Maggino; P Zola; B Sostegni; A Bellicini; L Fuso; R Cristofani; E Sartori Journal: Gynecol Oncol Date: 2014-04-24 Impact factor: 5.482
Authors: Shankar Siva; Alan Herschtal; Jessica M Thomas; David M Bernshaw; Suki Gill; Rodney J Hicks; Kailash Narayan Journal: Cancer Date: 2011-03-01 Impact factor: 6.860
Authors: Ingrid Hillesheim; Gabriel Augusto Limone; Lucia Klimann; Heleusa Monego; Marcia Appel; Alessandra de Souza; Ricardo Dos Reis Journal: Int J Gynecol Cancer Date: 2017-10 Impact factor: 3.437
Authors: D Bodurka-Bevers; M Morris; P J Eifel; C Levenback; M W Bevers; K R Lucas; J T Wharton Journal: Gynecol Oncol Date: 2000-08 Impact factor: 5.482