The Role of Lymph Node Downstaging Following Neoadjuvant Treatment in a Group of Patients with Advanced Stage Cervical Cancer
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total (33) | Alive at 3 Years (22) | Deceased at 3 Years (11) | p-Value | |
---|---|---|---|---|
Age, years, median (SD) | 55.3 (11.5) | 56 (14) | 54 (26) | 0.895 |
Environment, n (%) | urban: 12 (36) rural: 21 (64) | urban: 8 (36) rural: 14 (64) | urban: 4 (36) rural: 7 (64) | 0.801 |
Histological types of cancer, (biopsy) n (%) | 1. Squamous cell carcinoma 30 (90) 2. Adenocarcinoma-2 (6) 3. Adenosquamous carcinoma-1 (3) | 1. Squamous cell Carcinoma-20 (90) 2. Adenocarcinoma-1 (4) 3. Adenosquamous Carcinoma-1 (4) | 1. Squamous cell carcinoma-10 (90) 2. Adenocarcinoma-1 (9) | 0.687 |
Pre-RT FIGO stage, n (%) | III C1 33 (100) | IIIC1: 22 (100) | IIIC1: 11 (100) | 1 |
Pre-RT Parametrial Invasion n (%) | 19 (57) | 11 (50) | 8 (72) | 0.210 |
Initial Tumor size (cm), median (IQR) | 2 (1.6) | 1.95 (0.9) | 3 (2.5) | 0.048 |
Pre-RT leukocyte count, median (IQR) | 6200 (2000) | 6350 (2100) | 6050 (2700) | 0.825 |
Pre-RT hemoglobin, mean (SD) | 12.5 (1.4) | 12.8 (1.1) | 11.5 (1.3) | 0.03 |
Post-Neoadjuvant Treatment Adverse Reactions | Alive at 3 Years after Treatment | Dead at 3 Years after Treatment | p-Value |
---|---|---|---|
Radiation colitis | 0 | 1 | 0.33 |
Radiation cystitis | 0 | 4 | 0.008 |
Anemia | 6 | 7 | 0.06 |
Leukopenia | 1 | 3 | 0.09 |
Total (33) | Alive at 3 Years (22) | Deceased at 3 Years (11) | p-Value | |
---|---|---|---|---|
RT dose, median (IQR) | 50 (0.2) | 50 (0.4) | 50 (0) | 0.611 |
Nr. of RT sessions, median (IQR) | 25 (1) | 25 (1) | 25 (1) | 0.807 |
Sensitization chemotherapy, median (IQR) | 5 (5) | 5 (5) | 3 (5) | 0.440 |
Postoperatively chemotherapy, n (%) | 10 (30) | 5 (22) | 5 (45) | 0.181 |
Total (33) | Alive at 3 Years (22) | Deceased at 3 Years (11) | p-Value | |
---|---|---|---|---|
Post-RT FIGO stage, n (%) | Absence of tumor: 10 (30) IA1-2 (6) IA2-1 (3) IB1-10 (30) IB2-1 (3) IIA1-1 (3) IIA2-1 (3) IIB-1 (3) IIIA-1 (3) IIIC1-5 (15) | Absence of tumor: 10 (45) IA1-2 (9) IA2-0 (0) IB1-6 (27) IB2-0 (0) IIA1-1 (4) IIA2-0 (0) IIB-1 (5) IIIA-0 (0) IIIC1-2 (9) | Absence of tumor: 0 (0) IA1-0 (0) IA2-1 (9) IB1-4 (36) IB2-1 (9) IIA1-0 (0) IIA2-1 (9) IIB-0 (0) IIIA-1 (9) IIIC1-3 (27) | 0.121 |
Post-RT lymphadenopathy, n (%) | 5 (15) | 2 (9) | 3 (27) | 0.304 |
Preoperative leukocyte count, median (IQR) | 5600 (2100) | 5630 (2070) | 5600 (3500) | 0.721 |
Preoperative hemoglobin, mean (SD) | 11.9 (1.4) | 12.3 (1.2) | 11 (1.4) | 0.02 |
Intraoperative FIGO stage, n (%) | Absence of tumor: 15 (45) IA1-2 (6) IA2-3 (9) IB1-3 (9) IB2-0 (0) IIA1-1 (3) IIA2-1 (3) IIB-1 (3) IIIA-1 (3) IIIC1-4 (12) | Absence of tumor: 13 (59) IA1-1 (4) IA2-2 (9) IB1-1 (4) IB2-0 (0) IIA1-1 (4) IIA2-0 (0) IIB-1 (4) IIIA-0 (0) IIIC1-1 (4) | Absence of tumor: 2 (18) IA1-1 (9) IA2-1 (9) IB1-2 (18) IB2-0 (0) IIA1-0 (0) IIA2-1 (9) IIB-0 (0) IIIA-1 (9) IIIC1-3 (27) | 0.119 |
Intraoperative histological type of cancer n (%) | Absence of tumor: 15 (45) In situ carcinoma: 1 (3) Squamous cell carcinoma: 15 (45) 2. Adenocarcinoma: 1 (3) 3. Adenosquamous Carcinoma: 1 (3) | Absence of tumor: 13 (59) In situ carcinoma: 0 (0) Squamous cell carcinoma: 8 (36) 2. Adenocarcinoma: 0 (0) 3. Adenosquamous Carcinoma: 1 (4) | Absence of tumor: 2 (18) In situ carcinoma: 1 (9) Squamous cell Carcinoma: 7 (63) 2. Adenocarcinoma: 1 (9) 3. Adenosquamous Carcinoma: 0 (0) | |
Intraoperative parametrial Invasion n (%) | 2 (6) | 1(4) | 1(9) | 0.601 |
Positive intraoperative lymph nodes, n (%) | 3 (9) | 1 (4) | 2 (18) | 0.252 |
Lymphovascular invasion, n (%) | 7 (21) | 3 (13) | 4 (36) | 0.186 |
Factors | HR | CI | p-Value |
---|---|---|---|
Age | 0.987 | 0.935–1.041 | 0.621 |
Environment | 1.001 | 0.292–3.423 | 0.999 |
Histological types of cancer, (biopsy) | 1.241 | 0.159–9.706 | 0.979 |
Pre-RT hemoglobin | 0.702 | 0.397–0.912 | 0.005 |
Initial Tumor size | 1.746 | 1.248–2.441 | 0.001 |
Pre-RT parametrial invasion | 2.445 | 0.647–9.227 | 0.187 |
RT dose | 0.970 | 0.792–1.187 | 0.766 |
Nr. of RT sessions | 0.971 | 0.689–1.368 | 0.867 |
Post-RT Lymphadenopathy | 3.186 | 0.835–12.153 | 0.09 |
Post-RT FIGO | 2.965 | 0.972–7.842 | 0.573 |
Sensitization chemotherapy | 0.937 | 0.761–1.155 | 0.543 |
Pre-RT hemoglobin | 0.702 | 0.397–0.912 | 0.005 |
Preoperative hemoglobin | 0.506 | 0.325–0.789 | 0.003 |
Preoperative leukocyte count | 1.153 | 0.895–1.486 | 0.271 |
Intraoperative FIGO | 47.447 9.203 | 3.078–731.400 1.529–55.372 | Stage IIIA: 0.006 Stage IIIC1: 0.01 |
Intraoperative parametrial invasion | 2.162 | 0.275–16.970 | 0.600 |
Positive intraoperative lymph nodes | 4.064 | 0.862–19.164 | 0.076 |
Postoperatively chemotherapy | 2.617 | 0.795–8.610 | 0.113 |
Lymphovascular invasion | 3.04 | 0.885–10.442 | 0.07 |
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Dicu-Andreescu, I.-G.; Marincaș, M.-A.; Simionescu, A.-A.; Dicu-Andreescu, I.; Ionescu, S.-O.; Prunoiu, V.-M.; Brătucu, E.; Simion, L. The Role of Lymph Node Downstaging Following Neoadjuvant Treatment in a Group of Patients with Advanced Stage Cervical Cancer. Medicina 2024, 60, 871. https://doi.org/10.3390/medicina60060871
Dicu-Andreescu I-G, Marincaș M-A, Simionescu A-A, Dicu-Andreescu I, Ionescu S-O, Prunoiu V-M, Brătucu E, Simion L. The Role of Lymph Node Downstaging Following Neoadjuvant Treatment in a Group of Patients with Advanced Stage Cervical Cancer. Medicina. 2024; 60(6):871. https://doi.org/10.3390/medicina60060871
Chicago/Turabian StyleDicu-Andreescu, Irinel-Gabriel, Marian-Augustin Marincaș, Anca-Angela Simionescu, Ioana Dicu-Andreescu, Sînziana-Octavia Ionescu, Virgiliu-Mihail Prunoiu, Eugen Brătucu, and Laurențiu Simion. 2024. "The Role of Lymph Node Downstaging Following Neoadjuvant Treatment in a Group of Patients with Advanced Stage Cervical Cancer" Medicina 60, no. 6: 871. https://doi.org/10.3390/medicina60060871
APA StyleDicu-Andreescu, I.-G., Marincaș, M.-A., Simionescu, A.-A., Dicu-Andreescu, I., Ionescu, S.-O., Prunoiu, V.-M., Brătucu, E., & Simion, L. (2024). The Role of Lymph Node Downstaging Following Neoadjuvant Treatment in a Group of Patients with Advanced Stage Cervical Cancer. Medicina, 60(6), 871. https://doi.org/10.3390/medicina60060871