Neo-adjuvant treatment of adenocarcinoma and squamous cell carcinoma of the cervix results in significantly different pathological complete response rates

Autor: Philippe Tummers, Amin Makar, Pieter De Visschere, Mieke Van Bockstal, Eline Naert, Emiel De Jaeghere, Katrien Vandecasteele, Hannelore Denys, Jo Van Dorpe, Wilfried De Neve, Karen Couvreur
Přispěvatelé: UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anatomie pathologique
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Cancer Research
Survival
SURGERY
medicine.medical_treatment
Uterine Cervical Neoplasms
Gastroenterology
MODULATED ARC THERAPY
0302 clinical medicine
Recurrence
Squamous cell carcinoma
PROGNOSTIC-SIGNIFICANCE
Medicine and Health Sciences
RADICAL HYSTERECTOMY
Cervical cancer
Aged
80 and over
Standard treatment
UTERINE CERVIX
CHEMOTHERAPY
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
CANCER
Neoadjuvant Therapy
medicine.anatomical_structure
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Cohort
Carcinoma
Squamous Cell
Adenocarcinoma
Female
RADIOTHERAPY
Research Article
ADENOSQUAMOUS CARCINOMAS
Adult
medicine.medical_specialty
lcsh:RC254-282
03 medical and health sciences
Young Adult
STAGE IB
Internal medicine
Genetics
medicine
Humans
Pathological
Cervix
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Cancer
medicine.disease
Radiation therapy
stomatognathic diseases
030104 developmental biology
Lymph Nodes
Neoplasm Grading
business
Differences
Zdroj: BMC Cancer
BMC CANCER
BMC cancer, Vol. 18, no.1, p. 1101 [1-10] (2018)
BMC Cancer, Vol 18, Iss 1, Pp 1-10 (2018)
ISSN: 1471-2407
Popis: Background Previous studies on cervical cancer reported a worse outcome for adenocarcinoma (AC) compared with squamous cell carcinoma (SCC). Nevertheless, standard treatment remains identical. Insight in the impact of histological types on biological behavior and pathological complete response rates might result in a treatment paradigm shift. Methods Clinicopathological characteristics, survival rates and relapse patterns were compared between AC (n = 36) and SCC (n = 143) cervical cancer patients. Pathological response to treatment was evaluated in the patient subgroup treated with neo-adjuvant chemoradiation followed by surgery (NA-CRT group; n = 84). Results In the entire cohort, 5y Disease Specific Survival (DSS) was 97.1 and 84% for AC and SCC respectively (p = 0.150). In the NA-CRT group 5y DSS was 100 and 75.5% for AC and SCC respectively (p = 0.059). Relapse patterns did not differ significantly between AC and SCC in the entire cohort, or in the NA-CRT group. Adenocarcinoma patients treated with NA-CRT showed significantly less pathological complete response compared with SCC patients (AC = 7%, SCC = 43%, p = 0.027). Conclusions There were no statistically significant differences regarding relapse and DSS rates between SCC and AC in the entire cohort, or the NA-CRT group. However, a trend to better 5y DSS of AC in the NA-CRT group was observed. This analysis showed significant differences in treatment responses after NA-CRT: patients with AC responded remarkably less to chemoradiation, resulting in a significantly lower pathological complete response rate. These findings imply a need for a paradigm shift in the treatment of cervical AC patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-5007-0) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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