Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study
Identifieur interne : 000420 ( France/Analysis ); précédent : 000419; suivant : 000421Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study
Auteurs : Anne De La Rochefordiere [France] ; Youlia Kirova [France] ; Severine Alran [France] ; Corine Plancher [France] ; Virginie Fourchotte [France] ; Philippe Beuzeboc [France] ; Vincent De Margerie [France] ; Peter Petrow [France] ; Xavier Sastre-Garau [France] ; Vincent Servois [France] ; Suzy Scholl [France] ; Paul Cottu [France] ; Laurent Mignot [France] ; Patricia De Cremoux [France] ; Remy Salmon [France]Source :
- Clinical Medicine. Oncology [ 1177-9314 ] ; 2008.
Abstract
To evaluate the treatment results of patients (pts) with FIGO stage IB2, IIA, IIB cervical carcinoma (CC) treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy.
Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test.
Complete histological local-regional response was obtained in 56% of the pts (n = 39). Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%). All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%). Eight of 55 (11%) radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40%) radiological N1 (p = 0.03). Seventeen pts (25%) had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141), 38/70 patients (54.1%) are still alive and free of disease, 6 (8.6%) alive with disease, and 11 (15.8%) patients were lost for follow-up but free of disease.
The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.
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PubMed: 21892284
PubMed Central: 3161687
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PMC:3161687Le document en format XML
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<author><name sortKey="De Cremoux, Patricia" sort="De Cremoux, Patricia" uniqKey="De Cremoux P" first="Patricia" last="De Cremoux">Patricia De Cremoux</name>
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<wicri:regionArea>Surgery, for Gynaecology Study Group of the Institut Curie, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Clinical Medicine. Oncology</title>
<idno type="eISSN">1177-9314</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To evaluate the treatment results of patients (pts) with FIGO stage IB2, IIA, IIB cervical carcinoma (CC) treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy.</p>
</sec>
<sec><title>Methods</title>
<p>Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test.</p>
</sec>
<sec><title>Results</title>
<p>Complete histological local-regional response was obtained in 56% of the pts (n = 39). Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%). All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%). Eight of 55 (11%) radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40%) radiological N1 (p = 0.03). Seventeen pts (25%) had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141), 38/70 patients (54.1%) are still alive and free of disease, 6 (8.6%) alive with disease, and 11 (15.8%) patients were lost for follow-up but free of disease.</p>
</sec>
<sec><title>In conclusion</title>
<p>The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Benedet, J" uniqKey="Benedet J">J Benedet</name>
</author>
<author><name sortKey="Odicino, F" uniqKey="Odicino F">F Odicino</name>
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</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kim, Ds" uniqKey="Kim D">DS Kim</name>
</author>
<author><name sortKey="Moon, H" uniqKey="Moon H">H Moon</name>
</author>
<author><name sortKey="Kim, Kt" uniqKey="Kim K">KT Kim</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Benedetti Panici, P" uniqKey="Benedetti Panici P">P Benedetti-Panici</name>
</author>
<author><name sortKey="Greggi, S" uniqKey="Greggi S">S Greggi</name>
</author>
<author><name sortKey="Colombo, A" uniqKey="Colombo A">A Colombo</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Whitney, Cw" uniqKey="Whitney C">CW Whitney</name>
</author>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rose, P" uniqKey="Rose P">P Rose</name>
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<author><name sortKey="Watkins, E" uniqKey="Watkins E">E Watkins</name>
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</analytic>
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<biblStruct><analytic><author><name sortKey="Keys, Hm" uniqKey="Keys H">HM Keys</name>
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<author><name sortKey="Stehman, Fb" uniqKey="Stehman F">FB Stehman</name>
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</analytic>
</biblStruct>
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<author><name sortKey="Winter, K" uniqKey="Winter K">K Winter</name>
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<author><name sortKey="Morris, M" uniqKey="Morris M">M Morris</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Peters, Wa" uniqKey="Peters W">WA Peters</name>
</author>
<author><name sortKey="Liu, Py" uniqKey="Liu P">PY Liu</name>
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<author><name sortKey="Barret, Rj" uniqKey="Barret R">RJ Barret</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lanciano, R" uniqKey="Lanciano R">R Lanciano</name>
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<author><name sortKey="Calkins, A" uniqKey="Calkins A">A Calkins</name>
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<author><name sortKey="Bundy, Bn" uniqKey="Bundy B">BN Bundy</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Koh, Wj" uniqKey="Koh W">WJ Koh</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wong, Lc" uniqKey="Wong L">LC Wong</name>
</author>
<author><name sortKey="Ngan, Any" uniqKey="Ngan A">ANY Ngan</name>
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<author><name sortKey="Cheung, Dkl" uniqKey="Cheung D">DKL Cheung</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Barbera, L" uniqKey="Barbera L">L Barbera</name>
</author>
<author><name sortKey="Paszat, L" uniqKey="Paszat L">L Paszat</name>
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<author><name sortKey="Thomas, G" uniqKey="Thomas G">G Thomas</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Veersarn, V" uniqKey="Veersarn V">V Veersarn</name>
</author>
<author><name sortKey="Lorvidhaya, V" uniqKey="Lorvidhaya V">V Lorvidhaya</name>
</author>
<author><name sortKey="Kamnerdsupphon, P" uniqKey="Kamnerdsupphon P">P Kamnerdsupphon</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Classe, Jm" uniqKey="Classe J">JM Classe</name>
</author>
<author><name sortKey="Rauch, P" uniqKey="Rauch P">P Rauch</name>
</author>
<author><name sortKey="Rodier, Jf" uniqKey="Rodier J">JF Rodier</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mancuso, S" uniqKey="Mancuso S">S Mancuso</name>
</author>
<author><name sortKey="Smani, D" uniqKey="Smani D">D Smani</name>
</author>
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<author><name sortKey="Favale, B" uniqKey="Favale B">B Favale</name>
</author>
<author><name sortKey="Greggi, S" uniqKey="Greggi S">S Greggi</name>
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<author><name sortKey="Manfredi, R" uniqKey="Manfredi R">R Manfredi</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jurado, M" uniqKey="Jurado M">M Jurado</name>
</author>
<author><name sortKey="Martinez Monge, R" uniqKey="Martinez Monge R">R Martinez-Monge</name>
</author>
<author><name sortKey="Garcia Foncillas" uniqKey="Garcia Foncillas">Garcia-Foncillas</name>
</author>
<author><name sortKey="Azinovic, I" uniqKey="Azinovic I">I Azinovic</name>
</author>
<author><name sortKey="Aristu, J" uniqKey="Aristu J">J Aristu</name>
</author>
<author><name sortKey="Lopez Garcia" uniqKey="Lopez Garcia">Lopez-Garcia</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Houvenaeghel, G" uniqKey="Houvenaeghel G">G Houvenaeghel</name>
</author>
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</author>
<author><name sortKey="Buttarelli, M" uniqKey="Buttarelli M">M Buttarelli</name>
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</analytic>
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<biblStruct><analytic><author><name sortKey="Kirwan, Jm" uniqKey="Kirwan J">JM Kirwan</name>
</author>
<author><name sortKey="Symonds, P" uniqKey="Symonds P">P Symonds</name>
</author>
<author><name sortKey="Green, Ja" uniqKey="Green J">JA Green</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Morris, M" uniqKey="Morris M">M Morris</name>
</author>
<author><name sortKey="Eifel, Pj" uniqKey="Eifel P">PJ Eifel</name>
</author>
<author><name sortKey="Lu, J" uniqKey="Lu J">J Lu</name>
</author>
<author><name sortKey="Grigsby, Pw" uniqKey="Grigsby P">PW Grigsby</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bonner, Ja" uniqKey="Bonner J">JA Bonner</name>
</author>
<author><name sortKey="Harrari, Pm" uniqKey="Harrari P">PM Harrari</name>
</author>
<author><name sortKey="Giralt, J" uniqKey="Giralt J">J Giralt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Beriwal, S" uniqKey="Beriwal S">S Beriwal</name>
</author>
<author><name sortKey="Gan, Gn" uniqKey="Gan G">GN Gan</name>
</author>
<author><name sortKey="Heron, De" uniqKey="Heron D">DE Heron</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>Île-de-France</li>
</region>
<settlement><li>Paris</li>
</settlement>
</list>
<tree><country name="France"><region name="Île-de-France"><name sortKey="De La Rochefordiere, Anne" sort="De La Rochefordiere, Anne" uniqKey="De La Rochefordiere A" first="Anne" last="De La Rochefordiere">Anne De La Rochefordiere</name>
</region>
<name sortKey="Alran, Severine" sort="Alran, Severine" uniqKey="Alran S" first="Severine" last="Alran">Severine Alran</name>
<name sortKey="Beuzeboc, Philippe" sort="Beuzeboc, Philippe" uniqKey="Beuzeboc P" first="Philippe" last="Beuzeboc">Philippe Beuzeboc</name>
<name sortKey="Cottu, Paul" sort="Cottu, Paul" uniqKey="Cottu P" first="Paul" last="Cottu">Paul Cottu</name>
<name sortKey="De Cremoux, Patricia" sort="De Cremoux, Patricia" uniqKey="De Cremoux P" first="Patricia" last="De Cremoux">Patricia De Cremoux</name>
<name sortKey="De Margerie, Vincent" sort="De Margerie, Vincent" uniqKey="De Margerie V" first="Vincent" last="De Margerie">Vincent De Margerie</name>
<name sortKey="Fourchotte, Virginie" sort="Fourchotte, Virginie" uniqKey="Fourchotte V" first="Virginie" last="Fourchotte">Virginie Fourchotte</name>
<name sortKey="Kirova, Youlia" sort="Kirova, Youlia" uniqKey="Kirova Y" first="Youlia" last="Kirova">Youlia Kirova</name>
<name sortKey="Mignot, Laurent" sort="Mignot, Laurent" uniqKey="Mignot L" first="Laurent" last="Mignot">Laurent Mignot</name>
<name sortKey="Petrow, Peter" sort="Petrow, Peter" uniqKey="Petrow P" first="Peter" last="Petrow">Peter Petrow</name>
<name sortKey="Plancher, Corine" sort="Plancher, Corine" uniqKey="Plancher C" first="Corine" last="Plancher">Corine Plancher</name>
<name sortKey="Salmon, Remy" sort="Salmon, Remy" uniqKey="Salmon R" first="Remy" last="Salmon">Remy Salmon</name>
<name sortKey="Sastre Garau, Xavier" sort="Sastre Garau, Xavier" uniqKey="Sastre Garau X" first="Xavier" last="Sastre-Garau">Xavier Sastre-Garau</name>
<name sortKey="Scholl, Suzy" sort="Scholl, Suzy" uniqKey="Scholl S" first="Suzy" last="Scholl">Suzy Scholl</name>
<name sortKey="Servois, Vincent" sort="Servois, Vincent" uniqKey="Servois V" first="Vincent" last="Servois">Vincent Servois</name>
</country>
</tree>
</affiliations>
</record>
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