Review Article
Prognostic significance of the Central Tumor Size (CTS) in Cervical Cancer (CC) stages IIb and IIIb: What should we do with the FIGO staging system and therapeutic strategies?
Alejandro Soderini*, Alejandro Aragona, Agustin Quintaie, Horacio Moschen and Martín Mendez
Published: 17 March, 2021 | Volume 5 - Issue 1 | Pages: 002-005
Cervical cancer constitutes an issue in public health, becoming the leading cause of death by cancer in women between 20-40 years of age in Latin America. In Argentina 5000 new cases are diagnosed each year, where more than 56% are in advanced stages. The aim of the present current opinion or critical review article is to remark the importance of the prognostic significance of the Central Tumor Size in stages IIB and IIIB cervical cancer, as well as to propose a new FIGO Staging System for Cervical cancer and trying to find out a role for the different therapeutic strategies for those cases.
Read Full Article HTML
DOI: 10.29328/journal.acst.1001023
Cite this Article
Read Full Article PDF
Keywords:
Cervical cancer; Central tumor size; FIGO staging system; Neoadjuvant chemotherapy; Oncological treatments
References
- Soderini A, Cuneo N. Ninguna mujer debería morir por cáncer de cuello uterino (Editorial). Rev Soc Obstet Ginecol B Aires. 2013; 993: 91-3.
- Aragona A, SoderiniA, Moschen H, Bonavia E, Garrido R, et al. Elevada moratlidad por cancer de cérvico-uterino en mujeres jóvenes del Area Metropolitana de Buenos Aires. MEDICINA (Buenos Aires). 2018; 78: 234-242.
- Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018; 103: 356-387. PubMed: https://pubmed.ncbi.nlm.nih.gov/30100160/
- Soderini A, Aragona A, Cuneo N. El problema del cancer de cuello uterino. Experiencias actuales en Ginenecologia oncológica. Capítulo. 2018; 1: 23.
- Pecorelli S, Benedet JL, Creasman WT, Shepherd J. FIGO staging of gynecologic cancer. 1994-1997 FIGO Committee on Gynecologic Oncology. Int Federat Gynecol Obstetr. Int J Gynaecol Obstet. 1999; 64: 5-10. PubMed: https://pubmed.ncbi.nlm.nih.gov/10190664/
- Sardi J, Sananes C, Giaroli A, Rueda NG, di Paola G, et al. Is subradical surgical treatment for carcinoma of the cervix uteri stage IB logical? Gynecol Oncol. 1989; 32: 360-364.
- Ferreyra M, Soderini A, Sardi J, et al. Subradical treatment for carcinoma of the cervix IB, Dogma or utopia?. European School of Oncology in the First Latin-American Educational Convention. Buenos Aires. 1995.
- Sardi JE, Giaroli A, Sananes C. Long-term follow-up of the first randomized trial using neoadjuvant chemotherapy in stage Ib squamous carcinoma of the cervix: the final results. Gynecol Oncol. 1997; 67: 61-69. PubMed: https://pubmed.ncbi.nlm.nih.gov/9345358/
- Landoni F, Parma G, Peiretti M, Zanagnolo V, Sideri M, et al. Chemo-conization in early cervical cancer. Gynecol Oncol. 2007; 107: S125-126. PubMed: https://pubmed.ncbi.nlm.nih.gov/17727935/
- Dargent D. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation and subsequent pregnancy in the treatment of early invasive cervical cancer. Am J Obstet Gynecol. 2002; 187: 1728; 172. PubMed: https://pubmed.ncbi.nlm.nih.gov/12501097/
- Cibula D, Sláma J, Svárovský J, Fischerova D, Freitag P, et al. Abdominal radical trachelectomy in fertility-sparing treatment of early-stage cervical cancer.Int J Gynecol Cancer. 2009; 19: 1407-1411. PubMed: https://pubmed.ncbi.nlm.nih.gov/20009898/
- Robova H, Rob L, Halaska MJ, Pluta M, Skapa P, et al. Review ofneoadjuvantchemotherapyand trachelectomy: whichcervical cancerpatients would be suitable forneoadjuvantchemotherapyfollowed by fertility-sparing surgery? Curr Oncol Rep.2015; 17: 446. PubMed: https://pubmed.ncbi.nlm.nih.gov/25893880/
- Plante M. Bulky Early-StageCervical Cancer(2-4 cm Lesions): Upfront Radical Trachelectomy or NeoadjuvantChemotherapyFollowed by Fertility-Preserving Surgery: Which Is the Best Option? Int J GynecolCancer.2015; 25: 722-728. PubMed: https://pubmed.ncbi.nlm.nih.gov/25764351/
- Soderini A, Aragona A, Bonavía E, Vigh MP, Minaudo MV, et al. The abdominal radical trachelectomy sparing the uterine arteries (a.r.t.- s.u.a) & the pelvic autonomic plexus (p.p.a.p.) in cervical cancer (cc): oncological & fertility outcomes of this novel surgical technique: IGCS-0105 Cervical Cancer. Int J Gynecol Cancer. 2015; 25: 40-41. PubMed: https://pubmed.ncbi.nlm.nih.gov/25955922/
- Angioli R, Plotti F, Montera R, Aloisi A, Luvero D, et al. Neoadjuvantchemotherapyplus radical surgery followed bychemotherapyin locally advanced cervical cancer. Gynecol Oncol.2012; 127: 290-296. PubMed: https://pubmed.ncbi.nlm.nih.gov/22819938/
- Sananes C, Giaroli A,SoderiniA, Guardado N, Snaidas L, et al. Neoadjuvantchemotherapyfollowed by radical hysterectomy and postoperative adjuvant chemotherapyin the treatment of carcinoma of the cervix uteri: long-term follow-up of a pilot study. Eur J Gynaecol Oncol. 1998; 19: 368-373. PubMed: https://pubmed.ncbi.nlm.nih.gov/9744728/
- Kim HS,Sardi JE,Katsumata N,Ryu HS, Nam JH, et al. Efficacy ofneoadjuvantchemotherapyin patients with FIGO stage IB1 to IIAcervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol.2013; 39: 115-124. PubMed: https://pubmed.ncbi.nlm.nih.gov/23084091/
- Soderini A, Aragona A, Bonavía E. Neoadjuvant chemotherapy (NCH) followed by abdominal radical trachelectomy (ART) in cervical cancer: long term follow up results of the Buenos Aires experience. Adv Surg Res. 2017; 1: 7-12.
- Benedetti-Panici P, Greggi S, Colombo A, Amoroso M, Smaniotto D, et al. Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multicenter randomized study. J Clin Oncol.2002; 20: 179-188. PubMed: https://pubmed.ncbi.nlm.nih.gov/11773168/
- Choi YS,Sin JI, Kim JH, Ye GW, et al. Survival benefits of neoadjuvantchemotherapyfollowed by radical surgery versus radiotherapy in locally advanced chemoresistantcervical cancer. J Korean Med Sci. 2006; 21: 683-689. PubMed: https://pubmed.ncbi.nlm.nih.gov/16891813/
- Chang TC, Lai CH, Hong JH,Hsueh S, Huang KG, et al. Randomized trial ofneoadjuvantcisplatin, vincristine, bleomycin, and radical hysterectomy versus radiationtherapyfor bulky stage IB and IIAcervical cancer. J Clin Oncol. 2000; 18: 1740-1747. PubMed: https://pubmed.ncbi.nlm.nih.gov/10764435/
- Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer Meta-analysis Collaboration. Neoadjuvantchemotherapyfor locally advancedcervical cancer: a systematic review and meta-analysis of individual patient data from 21 randomized trials. Eur JCancer.2003; 39: 2470-286. PubMed: https://pubmed.ncbi.nlm.nih.gov/14602133/
- Lanowska M, Mangler M, Speiser D. GF Radical vaginal trachelectomy after laparoscopic staging andneoadjuvantchemotherapyin women with early-stagecervical cancerover 2 cm: oncologic, fertility, and neonatal outcome in a series of 20 patients. Int J GynecolCancer. 2014; 24: 586-593.
- Pareja R, Rendón GJ, Vasquez M, Echeverri L, Sanz-Lomana CM, et al. Immediate radical trachelectomy versusneoadjuvantchemotherapyfollowed by conservative surgery for patients with stage IB1cervical cancerwith tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes. Gynecol Oncol.2015. PubMed: https://pubmed.ncbi.nlm.nih.gov/25827293/
- Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri Int J Gynaecol Obstet. 2018; 143: 22-36. PubMed: https://pubmed.ncbi.nlm.nih.gov/30306584/
- Sardi J, Sananes C, Giaroli A. Neoadyuvant chemoteraphy in cervical carcinoma stage IIb: a randomized controlled trial. Int J Gyneco Cancer. 1998; 8: 441-450.
- Kim K, Chie EK, Wu HG, Ha SW, Kim JS, et al. Efficacy of paclitaxel and carboplatin as a regimen for postoperative concurrent chemoradiotherapy of high risk uterine cervix cancer. Gynecol Oncol. 2006; 101: 398-402. PubMed: https://pubmed.ncbi.nlm.nih.gov/16330087/
- McCormack M,Kadalayil L,Hackshawet, Hall-Craggs MA, Symonds RP, et al. A phase ii study of weeklyneoadjuvantchemotherapyfollowedby radicalchemoradiationfor locally advanced cervical cancer. JCancer.2013; 108: 2464-2469. PubMed: https://pubmed.ncbi.nlm.nih.gov/23695016/
- Rameri C, Silvade Azevedo A, Claudio SantosThuler L,Ferreira CG. Neoadjuvant Chemotherapy Followed by Chemoradiation in Cervical Carcinoma: A Review. Int J Gynecol Cancer.2016;26:729-736. PubMed: https://pubmed.ncbi.nlm.nih.gov/26905327/
- Hegazy H, Hegazy N,Soliman M. Study of neoadjuvant chemotherapy with a carboplatin and taxol followed by chemoradiation versus chemoradiation for locally advanced cervical cancer. Int J Gynecol Cancer. 2020;30:A14-A15.
- de Arruda FN, da Costa S, Bonadio R, Dornellas A, Pereira D, et al. Quality of life of locally advanced cervical cancer patients after neoadjuvant chemotherapy followed by chemoradiation versus chemoradiation alone (CIRCE trial): a randomized phase II trial. Int J Gynecol Cancer. 2020; 30: 749-756. PubMed: https://pubmed.ncbi.nlm.nih.gov/32321767/
- Guo L, Liu X, Wang L, Sun H, Huang K, et al. Outcome of international Federation of gynecology and obstetrics stage IIb cervical cancer from 2003 to 2012: an evaluation of treatments and prognosis: a retrospective study. Int J Gynecol Cancer.2015; 25: 910-918. PubMed: https://pubmed.ncbi.nlm.nih.gov/25867278/
- Greggi S, Kenter G, Vergote I. Results from neoadjuvant chemotherapy followed by surgery compared to chemoradiation for Stage IB2-IIB cervical cancer: EORTC55994. Int J Gyecol Cancer. 2019: 29.
- Soderini A, Aragona A, Quintaie A. Prognostic significance of the central tumor size (CTS) in stages IIB and IIIB bulky cervical cancer (CC): proposing a new FIGO staging system. Int J Gynecol Cancer. 2019;29:A91.
- Giaroli A, Sananes C, Sardi JE, Maya AG, Bastardas ML, et al. Lymph node metastases in carcinoma of the cervix uteri: response to neoadjuvantchemotherapyand its impact on survival. Gynecol Oncol. 1990; 39: 34-39. PubMed: https://pubmed.ncbi.nlm.nih.gov/1699852/
- Xie Q, Liang J, Rao Q, Xie X, Li R, et al. Aldehyde Dehydrogenase 1 Expression Predicts Chemoresistance and Poor Clinical Outcomes in Patients with Locally Advanced Cervical Cancer Treated with Neoadjuvant Chemotherapy Prior to Radical Hysterectomy. Ann Surg Oncol. 2016; 23: 163-170. PubMed: https://pubmed.ncbi.nlm.nih.gov/25916979/