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  • 1
    Electronic Resource
    Electronic Resource
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 2 (1992), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A clinicopathologic analysis of 70 patients treated by radiotherapy and/or chemotherapy following primary radical surgery has been undertaken. Clinical stage at presentation was IB (58 patients) and IIA (12 patients). Thirty-five patients (50%) had squamous carcinoma, 23 (33%) had adenosquamous carcinoma, 9 (13%) had adenocarcinoma and 3 (4%) had an undifferentiated neoplasm. The reasons for further treatment were: (i) pelvic lymph node metastases (PLNM), 35 (50%); (ii) inadequate central clearance (ICC), 13 (18%); (iii) recurrent disease (RD), 17 (24%); (iv) others, 5 (8%) cases. Sixty-seven patients had radiotherapy, one of whom also received adjuvant chemotherapy, three patients had chemotherapy alone, and 12 patients received chemotherapy for recurrence following radiotherapy. The 5-year survival in the above referral groups were: (i) 66%; (ii) 62%; (iii) 12%. The site of relapse following treatment was primarily pelvic in groups 2 (ICC) and 3 (RD) and extrapelvic in group 1 (PLNM). Of the histologic parameters studied the only factor of statistical significance in predicting outcome in this group who are recognized to have a generally poor prognosis was the presence of parametrial extension (P = 0.0066). Six cases (9%) developed complications following therapy, lymphoedema being the most common (66%).
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    International journal of gynecological cancer 1 (1991), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. Hale RJ, Buckley CH, Fox H, Wilcox FL, Tindall VR, Logue JP. The morphology and distribution of lymph node metastases in stage IB/IIA cervical carcinoma: relationship to prognosis. Int J Gynecol Cancer 1991; 1: 233–237.In this study 49 cases of stage IB/IIA cervical carcinoma with nodal metastases treated by Wertheim's hysterectomy have been examined. Note was made of the number of nodal metastases found, the site of the highest involved node and the pattern and extent of nodal infiltration. None of these parameters showed any significant effect on prognosis.These results suggest that in patients treated surgically for cervical carcinoma every lymph node should be thoroughly examined for the presence of metastatic tumor and where this is found, no matter how minimal, adjuvant therapy should be considered.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    International journal of gynecological cancer 1 (1991), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. A clinicopathological analysis of 235 patients with stage IB/IIA cervical carcinoma was performed. These patients represent all those treated between 1975 and 1989 inclusive by primary Wertheim's hysterectomy at St Mary's Hospital, Manchester. We found that a significantly higher proportion of tumors from patients under 40 years of age contained mucin and that overall the adenosquamous carcinomas had a significantly greater incidence of lymph node metastases (P= 0.00049). Pelvic lymph node metastases had no effect on prognosis in these adenosquamous carcinomas but did in squamous carcinomas (P= 0.0004) and adenocarcinomas (P= 0.0001). Univariate log-rank analysis showed that variables associated with survival were: pregnancy at diagnosis (P= 0.0238), lymphatic permeation (P 〈 0.0001), vascular permeation (P 〈 0.0001), lymph node metastases (P 〈 0.0001), tumor volume (P 〈 0.0001), canal length of tumor (P= 0.0009), cervical stromal tumor-free rim (P= 0.0027), parametrial extension (P= 0.0008) and adequacy of excision (P= 0.0389). In a multivariate regression analysis (Cox's regression model) lymphatic permeation, tumor volume, pregnancy at diagnosis and lymph node metastases were independent prognostic variables.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    International journal of gynecological cancer 2 (1992), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The 235 patients with stage IB/IIA cervical carcinoma treated by Wertheim’s hysterectomy, as a primary procedure, at St Mary’s Hospital, Manchester between 1975 and 1989 inclusive, form the basis of this study. Using Cox’s regression model, four variables were shown to have independent prognostic significance. These were: (1) lymphatic permeation (adjacent to the tumor); (2) tumor volume; (3) being pregnant at diagnosis and (4) lymph node metastases. A heuristic model was formulated which was based upon these four factors and by using this information it was possible to separate the patients into four distinct prognostic groups. It is suggested that this model may prove useful in identifying those patients at a higher risk of dying of disease and who would benefit from early adjuvant systemic therapy.
    Type of Medium: Electronic Resource
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