Intraperitoneal tumor spread in locally advanced cervical carcinoma undergoing neoadjuvant chemotherapy

S. Greggi, P. Benedetti-Panici, M. Amoroso, G. Scambia, M. P. Paratore, M. G. Salerno, I. Bezzi, S. Mancuso

Research output: Contribution to journalArticle

Abstract

The prognostic significance of peritoneal tumor involvement is still unclear, correlations with tumor characteristics are somewhat controversial, and little is known about the peritoneal influence of neoadjuvant chemotherapy and tumor extension in patients undergoing laparotomy following clinical response to neoadjuvant chemotherapy. In this study, 208 patients with previously untreated locally advanced cervical carcinoma were primarily treated by neoadjuvant chemotherapy. The 183 clinically responsive patients underwent laparotomy and, if judged to be radically operable, they were submitted to radical surgery. At laparotomy, 158 of the 183 patients (86%) were still amenable for radical surgery; 7 (4%) and 13 (7%) showed macroscopic and microscopic peritoneal tumor involvement, respectively. An intraperitoneal positive cytology was registered in 5 (3%) cases. Stage, histotype, and cervical tumor size were each independent predictors of peritoneal tumor involvement upon logistical analysis. The 10-year survival estimate of patients with no peritoneal tumor involvement was longer (72%) than that of patients with peritoneal tumor involvement (17%) (P = 0.001). Multivariate analysis showed that the peritoneal tumor involvement together with stage, pathological parametrial involvement, and lymph node status were independently associated with overall and disease-free survival. Adenocarcinomas have a higher propensity to peritoneal tumor involvement than squamous cell carcinomas; the incidence of atypical peritoneal cytology and, to a lesser extent, microscopic metastasis, are lower than expected in patients responsive to neoadjuvant chemotherapy, suggesting a possible effect on peritoneal tumor involvement by neoadjuvant chemotherapy. A positive relationship exists between tumor extent and peritoneal tumor involvement, even in a neoadjuvant chemotherapy setting. Peritoneal tumor involvement is an independent predictor of survival, but it is generally associated with other risk factors.

Original languageEnglish
Pages (from-to)207-214
Number of pages8
JournalInternational Journal of Gynecological Cancer
Volume8
Issue number3
DOIs
Publication statusPublished - 1998

Keywords

  • Intraperitoneal tumor spread
  • Locally advanced cervical cancer
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Cancer Research

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