Cervical Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Cervical Cancer, including details on symptoms, vaccine, screening, treatment, human papilloma virus (hpv), information.

Clear cell carcinoma of the cervix: a multi-institutional review in the post-DES era.

Thomas MB, Wright JD, Leiser AL, Chi DS, Mutch DG, Podratz KC, Dowdy SC

Division of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

OBJECTIVE: To conduct an outcome analysis of patients with cervical clear cell carcinoma (CCCC) in the post-DES era. METHODS: A retrospective review was conducted at 3 major gynecologic cancer centers of all primary CCCC between 1982 and 2004. RESULTS: CCCC was confirmed in 34 patients. Median age was 53 years. DES exposure was confirmed in 2 (6%) patients. A history of smoking was elicited in 22%, and of abnormal Pap smear 18% patients. Primary surgical resection was performed in all stage I or IIA patients (n=26); they displayed superior 3-year overall survival (OS) compared to advanced stage (n=8) patients (91% vs. 22%, p<0.001). Pelvic lymph node involvement was noted in 25%; all patients with positive para-aortic nodes (20% of patients sampled) had positive pelvic nodes. All node positive patients were treated with adjuvant radiation, but nevertheless displayed reduced progression free (31% vs 92%, p<0.001) and overall survival (80% vs. 100%, p=0.02). Adjuvant radiotherapy did not appear to impact OS in patients with negative lymph nodes. DISCUSSION: This series provides insight into the management of early stage CCCC in the post-DES era. Although these patients may be at slightly higher risk of nodal spread, clear cell histology by itself does not appear to portend a worse prognosis than squamous cell carcinoma of the cervix in the absence of traditional risk factors. Our data suggest that patients with low risk early stage CCCC may be managed with radical surgery alone, without the need for adjuvant chemotherapy or radiation.

Published 6 June 2008 in Gynecol Oncol, 109(3): 335-9.
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Articles on Cervical Cancer published 5 June 2008:

Chemoradiation with concomitant boost followed by radical surgery in locally advanced cervical cancer: a dose-escalation study.   Am J Clin Oncol, 31(3): 280-4.

OBJECTIVE: Aim of this study is to evaluate the feasibility of an accelerated fractionation radiotherapy by concomitant boost in locally advanced cervical cancer patients, to explore the maximum tolerated dose (MTD) of radiation through a dose-escalation scheme, and to verify if increasing the radiation dose would result in a higher rate of pathologic complete response. METHODS: During the first and the last week of treatment, a combination of cisplatin (20 mg/mq/d, IV, days 1-4) and ... [Abstract] [Full-text]

Articles on Cervical Cancer published 23 May 2008:

A combination of serum tumor markers identifies high-risk patients with early-stage squamous cervical cancer.   Tumour Biol, 29(1): 9-17.

We aimed to investigate whether pretreatment serum levels of squamous cell carcinoma (SCC) antigen (SCC-Ag), cytokeratin 19 (CYFRA 21-1) and two mucins (CA 15-3 and CA 125) identify patients with occult disease in early-stage SCC of the cervix. Therefore, pretreatment serum samples were obtained from 78 patients with SCC of the cervix (52 IB, 9 IIA and 18 IIB), and tumor markers were measured with commercial immunoassays. SCC-Ag, CYFRA 21-1 and CA 15-3 (analyzed as continuous variables) were ... [Abstract] [Full-text]

Articles on Cervical Cancer published 20 May 2008:

Polymorphisms in 9q32 and TSCOT are linked to cervical cancer in affected sib-pairs with high mean age at diagnosis.   Hum Genet, 123(5): 437-43.

Cervical cancer is a multifactorial disease influenced by both environmental and genetic factors. We have previously found linkage to 9q32 in a genomewide scan of affected sib-pairs (ASPs) with cervical cancer and to the thymic stromal co-transporter (TSCOT), a candidate gene in this region. Here we examined the contribution of 9q32 and TSCOT to cervical cancer susceptibility using at larger material of 641 ASPs, 278 of which were included in the earlier genome-scan. Since heritable forms of ... [Abstract] [Full-text]

Articles on Cervical Cancer published 19 May 2008:

Histologic results of para-aortic lymphadenectomy in patients treated for stage IB2/II cervical cancer with negative [18F]fluorodeoxyglucose positron emission tomography scans in the para-aortic area.   J Clin Oncol, 26(15): 2558-61.

PURPOSE: Histologic results of complete para-aortic lymphadenectomy were studied in patients treated for stage IB2/II cervical carcinoma who had no para-aortic uptake on [(18)F]fluorodeoxyglucose positron emission tomography combined with integrated computed tomography (FDG-PET/CT). PATIENTS AND METHODS: Patients were treated between 2004 and 2006 for stage IB2/II cervical cancer. Magnetic resonance imaging of the abdomen and pelvis and FDG-PET/CT were initially performed. Patients with no ... [Abstract] [Full-text]

Articles on Cervical Cancer published 14 May 2008:

DEK overexpression in uterine cervical cancers.   Pathol Int, 58(6): 378-82.

The purpose of the present paper was to investigate the significance of DEK protein expression in uterine cervical lesions and its relationship with HPV infection status. DEK protein expression was studied in 253 cervical lesions, including 30 non-neoplastic cervix with or without squamous metaplasia, 64 cervical intra-epithelial neoplasias (CIN; CIN-1, n = 28; CIN-2, n = 17; CIN-3, n = 19), 102 squamous cell carcinomas (SCC), 51 adenocarcinomas, and six adenosquamous cell carcinomas (adenoSCC) ... [Abstract] [Full-text]

Articles on Cervical Cancer published 13 May 2008:

Prevalence of type-specific HPV infection by age and grade of cervical cytology: data from the ARTISTIC trial.   Br J Cancer, 98(10): 1704-9.

Human papillomavirus (HPV) infection causes cervical cancer and premalignant dysplasia. Type-specific HPV prevalence data provide a basis for assessing the impact of HPV vaccination programmes on cervical cytology. We report high-risk HPV (HR-HPV) type-specific prevalence data in relation to cervical cytology for 24,510 women (age range: 20-64; mean age 40.2 years) recruited into the ARTISTIC trial, which is being conducted within the routine NHS Cervical Screening Programme in Greater ... [Abstract] [Full-text]

Articles on Cervical Cancer published 7 May 2008:

Screening-preventable cervical cancer risks: evidence from a nationwide audit in Sweden.   J Natl Cancer Inst, 100(9): 622-9.

BACKGROUND: The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear. Routine and comprehensive audits have been proposed as an ethically required component of screening. We performed a nationwide audit of the effectiveness of the Swedish cervical cancer screening program. METHODS: We identified all invasive cervical cancer cases that were diagnosed in Sweden from January 1, 1999, through December 31, 2001, ... [Abstract] [Full-text]

Articles on Cervical Cancer published 5 May 2008:

Inadequate screening in patients evaluated by nongynecologists for cervical cancer: a case control analysis.   Am J Obstet Gynecol, 198(5): e48-50.

OBJECTIVE: The purpose of this study was to determine the rate of unsatisfactory Papanicolaou tests between gynecology and nongynecology providers at a single institution. STUDY DESIGN: Vanderbilt University Medical Center data were used to obtain a list of all liquid-based cervical Papanicolaou smears that were collected between September 2002 and October 2006. Unsatisfactory samples were identified as 2 groups (gynecology vs nongynecology) for statistical comparison. RESULTS: There were ... [Abstract] [Full-text]

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