Abstract
Background To evaluate the feasibility and the predictive value of cone biopsy before performing radical hysterectomy in locally advanced cervical cancer patients showing complete clinical response to neo-Adjuvant chemoradiation. Methods Between March 2010 to March 2012 74 consecutive FIGO stage IIA2-IIB patients were submitted to neo-Adjuvant chemoradiation. All complete clinical responder patients were enrolled in this pilot trial. Results Fifty-seven out of 74 patients (77%) showed complete clinical response and were enrolled in the study. Forty-two out of 57 patients (74%) underwent successful pre-completion surgery cone biopsy with a median cone's tissue diameter of 24 mm (range 18-35). In 33 out of 42 patients (58%) a complete pathological response was found. In the remaining 5 (9%) and 4 (7%) a microscopic partial and partial response was found, respectively. All 33 cases (58%) with negative cone showed complete pathological response in the radical hysterectomy specimens. Patients with microscopic residual tumor foci in the cone showed negative residual cervical and paracervical tissue at definitive diagnosis, whereas in patients with partial response macroscopic residual disease in the surgical specimens was found. The negative predictive value of cone biopsy, MRI and PET/CT in the prediction of pathological status of the cervical and paracervical tissue was 100%, 79% and 79%, respectively (Table 2). Conclusions In this study we observed that, in locally advanced cervical patients showing complete clinical response to neo-Adjuvant chemoradiation, the cone biopsy feasibility was almost 75%, and that there is a complete pathological correspondence between cone and definitive pathology.
| Original language | English |
|---|---|
| Pages (from-to) | 1025-1029 |
| Number of pages | 5 |
| Journal | European Journal of Surgical Oncology |
| Volume | 39 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sep 2013 |
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Keywords
- Cervical cancer
- Chemoradiation
- Cone biopsy
- Radical hysterectomy
ASJC Scopus subject areas
- Oncology
- Surgery
Cite this
Pre-hysterectomy cone biopsy is able to predict response in locally advanced cervical cancer patients submitted to neo-Adjuvant chemoradiation. / Fanfani, F.; Fagotti, A.; Gagliardi, M. L.; Ferrandina, G.; Monterossi, G.; Gallotta, V.; Zannoni, G. F.; Scambia, G.
In: European Journal of Surgical Oncology, Vol. 39, No. 9, 09.2013, p. 1025-1029.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pre-hysterectomy cone biopsy is able to predict response in locally advanced cervical cancer patients submitted to neo-Adjuvant chemoradiation
AU - Fanfani, F.
AU - Fagotti, A.
AU - Gagliardi, M. L.
AU - Ferrandina, G.
AU - Monterossi, G.
AU - Gallotta, V.
AU - Zannoni, G. F.
AU - Scambia, G.
PY - 2013/9
Y1 - 2013/9
N2 - Background To evaluate the feasibility and the predictive value of cone biopsy before performing radical hysterectomy in locally advanced cervical cancer patients showing complete clinical response to neo-Adjuvant chemoradiation. Methods Between March 2010 to March 2012 74 consecutive FIGO stage IIA2-IIB patients were submitted to neo-Adjuvant chemoradiation. All complete clinical responder patients were enrolled in this pilot trial. Results Fifty-seven out of 74 patients (77%) showed complete clinical response and were enrolled in the study. Forty-two out of 57 patients (74%) underwent successful pre-completion surgery cone biopsy with a median cone's tissue diameter of 24 mm (range 18-35). In 33 out of 42 patients (58%) a complete pathological response was found. In the remaining 5 (9%) and 4 (7%) a microscopic partial and partial response was found, respectively. All 33 cases (58%) with negative cone showed complete pathological response in the radical hysterectomy specimens. Patients with microscopic residual tumor foci in the cone showed negative residual cervical and paracervical tissue at definitive diagnosis, whereas in patients with partial response macroscopic residual disease in the surgical specimens was found. The negative predictive value of cone biopsy, MRI and PET/CT in the prediction of pathological status of the cervical and paracervical tissue was 100%, 79% and 79%, respectively (Table 2). Conclusions In this study we observed that, in locally advanced cervical patients showing complete clinical response to neo-Adjuvant chemoradiation, the cone biopsy feasibility was almost 75%, and that there is a complete pathological correspondence between cone and definitive pathology.
AB - Background To evaluate the feasibility and the predictive value of cone biopsy before performing radical hysterectomy in locally advanced cervical cancer patients showing complete clinical response to neo-Adjuvant chemoradiation. Methods Between March 2010 to March 2012 74 consecutive FIGO stage IIA2-IIB patients were submitted to neo-Adjuvant chemoradiation. All complete clinical responder patients were enrolled in this pilot trial. Results Fifty-seven out of 74 patients (77%) showed complete clinical response and were enrolled in the study. Forty-two out of 57 patients (74%) underwent successful pre-completion surgery cone biopsy with a median cone's tissue diameter of 24 mm (range 18-35). In 33 out of 42 patients (58%) a complete pathological response was found. In the remaining 5 (9%) and 4 (7%) a microscopic partial and partial response was found, respectively. All 33 cases (58%) with negative cone showed complete pathological response in the radical hysterectomy specimens. Patients with microscopic residual tumor foci in the cone showed negative residual cervical and paracervical tissue at definitive diagnosis, whereas in patients with partial response macroscopic residual disease in the surgical specimens was found. The negative predictive value of cone biopsy, MRI and PET/CT in the prediction of pathological status of the cervical and paracervical tissue was 100%, 79% and 79%, respectively (Table 2). Conclusions In this study we observed that, in locally advanced cervical patients showing complete clinical response to neo-Adjuvant chemoradiation, the cone biopsy feasibility was almost 75%, and that there is a complete pathological correspondence between cone and definitive pathology.
KW - Cervical cancer
KW - Chemoradiation
KW - Cone biopsy
KW - Radical hysterectomy
UR - http://www.scopus.com/inward/record.url?scp=84883785398&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883785398&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2013.06.003
DO - 10.1016/j.ejso.2013.06.003
M3 - Article
C2 - 23827381
AN - SCOPUS:84883785398
VL - 39
SP - 1025
EP - 1029
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 9
ER -