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Tumor heterogeneity of FIGO stage III carcinoma of the uterine cervix

Authors
 YONG BAE KIM  ;  IK JAE LEE  ;  SONG YIH KIM  ;  JUN WON KIM  ;  HONG IN YOON  ;  SANG WUN KIM  ;  SUNGHOON KIM  ;  YOUNG TAE KIM  ;  CHANG OK SUH  ;  GWI EON KIM 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.75(5) : 1323-1328, 2009 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2009
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/radiotherapy ; Adult ; Aged ; Aged, 80 and over ; Brachytherapy/methods ; Carcinoma/mortality ; Carcinoma/pathology* ; Carcinoma/radiotherapy ; Carcinoma, Large Cell/mortality ; Carcinoma, Large Cell/pathology ; Carcinoma, Large Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/radiotherapy ; Chi-Square Distribution ; Female ; Humans ; Middle Aged ; Neoplasm Staging/methods* ; Survival Rate ; Treatment Outcome ; TumorBurden ; UterineCervicalNeoplasms/mortality ; UterineCervicalNeoplasms/pathology* ; UterineCervicalNeoplasms/radiotherapy
Abstract
PURPOSE: The purpose of this study was to analyze tumor heterogeneity based on tumor extent and suggest reappraisal of the system of the International Federation of Gynecology and Obstetrics (FIGO) for Stage III carcinoma of the uterine cervix from a radiotherapeutic viewpoint.

METHODS AND MATERIALS: Between 1986 and 2004, 407 patients with FIGO Stage III (FIGO Stage IIIa in 19 and IIIb in 388) were treated with external beam radiotherapy (RT) and high-dose rate brachytherapy. All patients were reviewed with respect to tumor extent. Patterns of failure and survival parameters were analyzed by use of the chi(2) test and Kaplan-Meier method.

RESULTS: The complete response rate was 79.6%, and the 5-year overall survival rates for Stage IIIa and Stage IIIb carcinoma of the cervix were 82.1% and 54.8%, respectively. To determine which parameters of tumor extent had an influence on prognosis for Stage IIIb patients, pelvic wall (PW) extension and hydronephrosis (HD) retained significance on multivariate analysis. Stage IIIb patients were divided into three subgroups according to PW extension and HD: low risk (unilateral PW extension without HD), intermediate risk (HD without PW extension or bilateral PW extension without HD), and high risk (unilateral or bilateral PW extension with HD). The high-risk group had a remarkably low complete response rate, high locoregional failure rate, and low 5-year survival rate compared with the intermediate- and low-risk groups.

CONCLUSIONS: FIGO Stage III carcinoma of the cervix covers considerably heterogeneous subgroups according to tumor extent. Before initiation of treatment, we suggest that physicians determine a tailored treatment policy based on tumor heterogeneity for each Stage III patient
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301609002065
DOI
10.1016/j.ijrobp.2008.12.081
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gwi Eon(김귀언)
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105540
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