TY - JOUR
T1 - Rethinking the significance of surgery for uterine cervical cancer
AU - Shimada, Muneaki
AU - Tsuji, Keita
AU - Shigeta, Shogo
AU - Nagai, Tomoyuki
AU - Watanabe, Zen
AU - Tokunaga, Hideki
AU - Kigawa, Junzo
AU - Yaegashi, Nobuo
N1 - Funding Information:
The authors thank the women and their families for their cooperation in JGOG1072s. We also thank the members of JGOG for their contribution to the establishment of JGOG real‐world database by JGOG1072s and their help with retrospective analysis. In particular, we would like to express our sincere gratitude to Professor Koji Matsuo (University of Southern California) and Professor Mikio Mikami (Tokai University) for their special guidance. This work was supported by JSPS KAKENHI with following grant number: JP17K11265 (to Muneaki Shimada)
Funding Information:
The authors thank the women and their families for their cooperation in JGOG1072s. We also thank the members of JGOG for their contribution to the establishment of JGOG real-world database by JGOG1072s and their help with retrospective analysis. In particular, we would like to express our sincere gratitude to Professor Koji Matsuo (University of Southern California) and Professor Mikio Mikami (Tokai University) for their special guidance. This work was supported by JSPS KAKENHI with following grant number: JP17K11265 (to Muneaki Shimada)
Publisher Copyright:
© 2021 Japan Society of Obstetrics and Gynecology.
PY - 2022/3
Y1 - 2022/3
N2 - Background: Treatment strategies based on histological subtypes are unestablished. Aims: Rethinking the significance of surgery for uterine cervical cancer. Methods: Using the database of cervical cancer stages IB–IIB with extensive hysterectomy (Federation of Gynecology and Obstetrics [FIGO] 2008) established by the Japanese Gynecologic Oncology Group network, we conducted a clinicopathological study of cervical cancer cases reclassified according to the FIGO 2018 staging. In stage IB (FIGO 2018) cervical cancer patients, there was no significant difference in treatment outcome according to histological type, but in stages IIA, IIB, and IIIC1 (FIGO 2018), the treatment outcome of nonsquamous cell carcinoma was significantly worse than that of squamous cell carcinoma. Considering post-treatment health care, it is important to consider ovarian preservation in young patients with cervical cancer, up to stage IIA (FIGO 2018) for squamous cell carcinoma and stage IB1 (FIGO 2018) for nonsquamous cell carcinoma, after careful evaluation of clinicopathological factors before surgery. Discussion: Locally advanced adenocarcinoma of the cervix is a rare and refractory cancer that has been shown to have low radiosensitivity, and its treatment outcome is still unsatisfactory. A new therapeutic strategy involving multidisciplinary treatment in combination with perioperative chemotherapy at a facility that can provide highly curative surgical treatment is desired. Conclusion: Minimally invasive surgery is being introduced for the treatment of early-stage cervical cancer. However, the number of eligible cases should be expanded in a phased manner, based on an objective evaluation of surgical outcomes at the facilities. Omics analysis may be useful to develop a new treatment for human papillomavirus nonrelated cervical cancer, represented by gastric mucinous carcinoma.
AB - Background: Treatment strategies based on histological subtypes are unestablished. Aims: Rethinking the significance of surgery for uterine cervical cancer. Methods: Using the database of cervical cancer stages IB–IIB with extensive hysterectomy (Federation of Gynecology and Obstetrics [FIGO] 2008) established by the Japanese Gynecologic Oncology Group network, we conducted a clinicopathological study of cervical cancer cases reclassified according to the FIGO 2018 staging. In stage IB (FIGO 2018) cervical cancer patients, there was no significant difference in treatment outcome according to histological type, but in stages IIA, IIB, and IIIC1 (FIGO 2018), the treatment outcome of nonsquamous cell carcinoma was significantly worse than that of squamous cell carcinoma. Considering post-treatment health care, it is important to consider ovarian preservation in young patients with cervical cancer, up to stage IIA (FIGO 2018) for squamous cell carcinoma and stage IB1 (FIGO 2018) for nonsquamous cell carcinoma, after careful evaluation of clinicopathological factors before surgery. Discussion: Locally advanced adenocarcinoma of the cervix is a rare and refractory cancer that has been shown to have low radiosensitivity, and its treatment outcome is still unsatisfactory. A new therapeutic strategy involving multidisciplinary treatment in combination with perioperative chemotherapy at a facility that can provide highly curative surgical treatment is desired. Conclusion: Minimally invasive surgery is being introduced for the treatment of early-stage cervical cancer. However, the number of eligible cases should be expanded in a phased manner, based on an objective evaluation of surgical outcomes at the facilities. Omics analysis may be useful to develop a new treatment for human papillomavirus nonrelated cervical cancer, represented by gastric mucinous carcinoma.
KW - chemotherapy
KW - concurrent chemoradiotherapy
KW - histological type
KW - surgery
KW - uterine cervical cancer
UR - http://www.scopus.com/inward/record.url?scp=85121563053&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85121563053&partnerID=8YFLogxK
U2 - 10.1111/jog.15112
DO - 10.1111/jog.15112
M3 - Article
C2 - 34908207
AN - SCOPUS:85121563053
SN - 1341-8076
VL - 48
SP - 576
EP - 586
JO - Journal of Obstetrics and Gynaecology Research
JF - Journal of Obstetrics and Gynaecology Research
IS - 3
ER -
