Chemotherapy Versus Chemoradiotherapy for FIGO Stages IB1 and IIA1 Cervical Squamous Cancer Patients with Lymphovascular Space Invasion: a Retrospective Study

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2022 Feb 23

PMID 35193525

Authors

Hao Zhang

Rao Yu

Lan Zhang

Rong Wang

Lin Xiao

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the impact of different adjuvant therapy on IB1 and IIA1 stage cervical squamous cell cancer patients with lymphovascular space invasion. It also aimed to analyze the relationship between lymphovascular space invasion and other clinical pathological characteristics on IB1 and IIA1 stage cervical squamous cell cancer patients.

Methods: This retrospective observational study collected data of FIGO stages IB1 and IIA1 squamous cervical cancer patients at the First Affiliated Hospital of Chongqing Medical University between 2014 and 2018. A correlation analysis between lymphovascular space invasion and other clinical or pathological factors was conducted. Prognosis analysis of patients with lymphovascular space invasion were performed to assess associations between clinical-pathological characteristics and survival.

Results: A total of 357 women were identified including 110 (30.8%) with lymphovascular space invasion, 247 (69.2%) without lymphovascular space invasion. Both middle 1/3 cervical stromal invasion (p = 0.000) and deep 1/3 cervical stromal invasion (p = 0.000) were independently associated with lymphovascular space invasion. Among lymphovascular space involved women, tumor differentiation (P = 0.001) and postoperative therapy (P = 0.036) had a significant influence on disease recurrence. Multivariate analysis showed that lymph node metastasis (P = 0.017), poorer tumor differentiation (P = 0.036) and postoperative chemotherapy alone (P = 0.021) can increase the risk of tumor relapse.

Conclusion: Our study suggested that the presence of deep stromal invasion independently increases the risk of lymphovascular space invasion. Compared with chemotherapy, chemoradiotherapy seems to improve progression-free survival in squamous cervical cancer patients with lymphovascular space invasion.

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References

Matsuo K, Mandelbaum R, Machida H, Purushotham S, Grubbs B, Roman L . Association of tumor differentiation grade and survival of women with squamous cell carcinoma of the uterine cervix. J Gynecol Oncol. 2018; 29(6):e91. PMC: 6189431. DOI: 10.3802/jgo.2018.29.e91. View

Takekuma M, Kasamatsu Y, Kado N, Kuji S, Tanaka A, Takahashi N . The issues regarding postoperative adjuvant therapy and prognostic risk factors for patients with stage I-II cervical cancer: A review. J Obstet Gynaecol Res. 2017; 43(4):617-626. DOI: 10.1111/jog.13282. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Bhatla N, Aoki D, Sharma D, Sankaranarayanan R . Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018; 143 Suppl 2:22-36. DOI: 10.1002/ijgo.12611. View

Hahn H, Lee I, Kim T, Lee K, Shim J, Kim J . Lymphovascular space invasion is highly associated with lymph node metastasis and recurrence in endometrial cancer. Aust N Z J Obstet Gynaecol. 2013; 53(3):293-7. DOI: 10.1111/ajo.12089. View

Yan W, Qiu S, Ding Y, Zhang Q, Si L, Lv S . Prognostic value of lymphovascular space invasion in patients with early stage cervical cancer in Jilin, China: A retrospective study. Medicine (Baltimore). 2019; 98(40):e17301. PMC: 6783197. DOI: 10.1097/MD.0000000000017301. View

Li L, Song X, Liu R, Li N, Zhang Y, Cheng Y . Chemotherapy versus radiotherapy for FIGO stages IB1 and IIA1 cervical carcinoma patients with postoperative isolated deep stromal invasion: a retrospective study. BMC Cancer. 2016; 16:403. PMC: 4936260. DOI: 10.1186/s12885-016-2447-2. View

Matsuo K, Garcia-Sayre J, Medeiros F, Casabar J, Machida H, Moeini A . Impact of depth and extent of lymphovascular space invasion on lymph node metastasis and recurrence patterns in endometrial cancer. J Surg Oncol. 2015; 112(6):669-76. PMC: 7526048. DOI: 10.1002/jso.24049. View

Barton M, Frommer M, Shafiq J . Role of radiotherapy in cancer control in low-income and middle-income countries. Lancet Oncol. 2006; 7(7):584-95. DOI: 10.1016/S1470-2045(06)70759-8. View

10.

Zhu J, Cao L, Wen H, Bi R, Wu X, Ke G . The clinical and prognostic implication of deep stromal invasion in cervical cancer patients undergoing radical hysterectomy. J Cancer. 2020; 11(24):7368-7377. PMC: 7646159. DOI: 10.7150/jca.50752. View

11.

Liu Y, Huang S, Ming X, Jing H, Li Z . Surgical Approach and Use of Uterine Manipulator Are Not Associated with LVSI in Surgery for Early-stage Cervical Cancer. J Minim Invasive Gynecol. 2021; 28(9):1573-1578. DOI: 10.1016/j.jmig.2021.01.013. View

12.

Kim K, Kang S, Chung H, Kim J, Park N, Song Y . Comparison of chemoradiation with radiation as postoperative adjuvant therapy in cervical cancer patients with intermediate-risk factors. Eur J Surg Oncol. 2008; 35(2):192-6. DOI: 10.1016/j.ejso.2008.04.004. View

13.

Kim H, Park W, Kim Y, Kim Y . Chemoradiotherapy is not superior to radiotherapy alone after radical surgery for cervical cancer patients with intermediate-risk factor. J Gynecol Oncol. 2020; 31(3):e35. PMC: 7189075. DOI: 10.3802/jgo.2020.31.e35. View

14.

Ho C, Chien T, Huang S, Wu C, Shih B, Chang S . Multivariate analysis of the prognostic factors and outcomes in early cervical cancer patients undergoing radical hysterectomy. Gynecol Oncol. 2004; 93(2):458-64. DOI: 10.1016/j.ygyno.2004.01.026. View

15.

Dos Reis R, Burzawa J, Tsunoda A, Hosaka M, Frumovitz M, Westin S . Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer. Int J Gynecol Cancer. 2015; 25(7):1292-9. PMC: 4549160. DOI: 10.1097/IGC.0000000000000490. View

16.

Ryu S, Park S, Nam B, Cho C, Kim K, Kim B . Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors?. Int J Radiat Oncol Biol Phys. 2010; 79(3):794-9. DOI: 10.1016/j.ijrobp.2009.11.019. View

17.

Matsuo K, Shimada M, Yokota H, Satoh T, Katabuchi H, Kodama S . Effectiveness of adjuvant systemic chemotherapy for intermediate-risk stage IB cervical cancer. Oncotarget. 2018; 8(63):106866-106875. PMC: 5739780. DOI: 10.18632/oncotarget.22437. View

18.

. Integrated genomic and molecular characterization of cervical cancer. Nature. 2017; 543(7645):378-384. PMC: 5354998. DOI: 10.1038/nature21386. View

19.

Azevedo A, Follain G, Patthabhiraman S, Harlepp S, Goetz J . Metastasis of circulating tumor cells: favorable soil or suitable biomechanics, or both?. Cell Adh Migr. 2015; 9(5):345-56. PMC: 4955369. DOI: 10.1080/19336918.2015.1059563. View

20.

Veade A, Foote J, Ehrisman J, Broadwater G, Davidson B, Lee P . Associations between lymphovascular space invasion, nodal recurrence, and survival in patients with surgical stage I endometrioid endometrial adenocarcinoma. World J Surg Oncol. 2019; 17(1):80. PMC: 6511118. DOI: 10.1186/s12957-019-1620-x. View