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Cited by 43Endometrial and Cervical Cancer TreatmentsCervical Cancer and HPV ResearchOvarian cancer diagnosis and treatment

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Clinical outcome of recurrent locally advanced cervical cancer (LACC) submitted to primary multimodality therapies

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Legge, F., Chiantera, V., Macchia, G., Fagotti, A., Fanfani, F., Ercoli, A., Gallotta, V., Morganti, A.G., Valentini, V., Scambia, G., Ferrandina, G.·2015·Gynecologic Oncology
DOI 10.1016/j.ygyno.2015.04.035
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Abstract

Objectives Recurrence of disease represents a clinical challenge in cervical cancer patients, especially when all available treatment modalities have been used in the primary setting. The aim of this study was to analyze the patterns of recurrence and their association with clinical outcome in locally advanced cervical cancer (LACC) patients submitted to primary chemoradiation (CTRT) followed by radical surgery (RS). Methods This study was conducted on 364 LACC patients treated with CTRT plus RS since January 1996 to July 2012. For each relapse, information on date of clinical/pathological recurrence, and pattern of disease presentation were retrieved. Post-relapse survival (PRS) was recorded from the date of recurrence to the date of death for disease or last seen. Survival probabilities were compared by the log rank test. Cox's regression model with stepwise variable selection was used for multivariate prognostic analysis for PRS. Results Within a median follow-up of 42months, 75 recurrences (20.6%) and 54 disease-associated deaths (14.8%) were recorded. By analysing the pattern of relapse, most of the recurrences were outside the irradiated field (n=43, 57.3%) and the most frequently observed site was visceral (n=16, 21.3%). Among the parameters of the recurrence associated with PRS including the pattern of recurrence, the size of recurrence, SCC-Ag serum levels at recurrence, and secondary radical surgery, only the last one retained an independent predictive role in reducing the risk of death (p=0.037). Conclusions The feasibility of secondary radical resection positively impacts on PRS of LACC patients submitted to multimodality primary treatments.

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  • The efficacy of DNA damaging-based therapies is limited by toxicities and the acquisition of therapy resistance, particularly associated with a suboptimal regression during radiotherapy of CC patients.

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Metadata

Authors
Legge, F., Chiantera, V., Macchia, G., Fagotti, A., Fanfani, F., Ercoli, A., Gallotta, V., Morganti, A. G., Valentini, V., Scambia, G., & Ferrandina, G.
Affiliations
  • Ospedale Generale Regionale Francesco Miulli (IT)
  • University of Perugia (IT)
  • Università Cattolica del Sacro Cuore (IT)
  • Policlinico Abano Terme (IT)
Corresponding author
Legge, F.
ORCID
Venue
Gynecologic Oncology
Publisher
Elsevier BV
Published
2015-07
Volume
138
Issue
1
Pages
83-88
ISSN
0090-8258 (ISSN-L)
DOI
10.1016/j.ygyno.2015.04.035
OpenAlex
W2009679513
Cited by
43
References
0
Citations by year
2025: 1 · 2024: 4 · 2023: 2 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 2 · 2016: 4 · 2015: 1
FWCI
4.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Gynecologic Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
  • PubliCatt (Università Cattolica del Sacro Cuore) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Oncology › Ovarian cancer diagnosis and treatment
Keywords
locally advanced cervical cancer, recurrent cervical cancer, chemoradiotherapy, radical surgery, recurrence patterns, survival after relapse, prognostic factors, carcinoembryonic antigen
MeSH terms
Adult, Uterine Cervical Neoplasms, Female, Humans, Neoplasm Recurrence, Local, Retrospective Studies, Survival Analysis, Treatment Outcome, Neoadjuvant Therapy, Chemoradiotherapy, Adjuvant

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