Neoadjuvant brachytherapy and chemotherapy followed by radical surgery for stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation

Ma,Yaomei; Zhao,Guiling; Qi,Ji; Sun,Peisong; Liu,Caiyan; Qu,Pengpeng; Chan,Karen  K.L.

doi:10.3892/mco.2018.1580

Neoadjuvant brachytherapy and chemotherapy followed by radical surgery for stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation

Authors:
- Yaomei Ma
- Guiling Zhao
- Ji Qi
- Peisong Sun
- Caiyan Liu
- Pengpeng Qu
- Karen K.L. Chan
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Affiliations: Department of Gynecological Oncology, Tianjin Central Hospital of Obstetrics and Gynecology, Nankai, Tianjin 300241, P.R. China, Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR 999077, P.R. China
Published online on: February 20, 2018 https://doi.org/10.3892/mco.2018.1580
Pages: 617-622

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Abstract

The aim of the present study was to assess the immediate and long-term results of preoperative brachytherapy and chemotherapy followed by radical surgery compared with those of standard chemoirradiation in patients with stage IB2-IIA cervical cancer. The medical records of 70 patients with stage IB2 and IIA cervical cancer who were treated between June 2006 and June 2010 were reviewed. The patients received either standard chemoirradiation (CRT) treatment (n=20) or neoadjuvant brachytherapy with one cycle of chemotherapy followed by radical hysterectomy [operation (OT) group; n=50]. Further adjuvant chemoirradiation was administered to patients with high-risk disease. Early and late complications as well as survival were compared between the two groups. No serious operative complications occurred in the OT group. In the CRT group, the incidence of symptomatic vaginal stenosis, as well as that of proctitis and cystitis, was higher compared with that in the OT group (35 vs. 4% and 20 vs. 2%, repectively). The median follow-up period was 52 months (range, 11-84 months). In the CRT group, the 3‑year overall and disease-free survival rates were 95% [95% confidence interval (CI): 76.14‑86.46] and 90% (95% CI: 59.94‑73.66), respectively, whereas in the OT group, the respective rates were 90% (95% CI: 72.93‑83.07) and 90% (95% CI: 71.84‑82.96). In conclusion, the survival of patients with stage IB2‑IIA cervical cancer treated with preoperative brachytherapy and chemotherapy followed by radical surgery was similar to that of patients treated with chemoirradiation, but with a more favorable side effect profile. Thus, this tri‑modal treatment option requires further evaluation in prospective randomized studies.

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1	Chiodini S, Luciani LG, Cai T, Molinari A, Morelli L, Cantaloni C, Barbareschi M and Malossini G: Unusual case of locally advanced and metastatic paratesticular liposarcoma: A case report and review of the literature. Arch Ital Urol Androl. 87:87–89. 2015. View Article : Google Scholar : PubMed/NCBI
2	Sopena-Sutil R, Silan F, Butron-Vila MT, Guerrero-Ramos F, Lagaron-Comba E and Passas-Martinez J: Multidisciplinary approach to giant paratesticular liposarcoma. Can Urol Assoc J. 10:E316–E319. 2016. View Article : Google Scholar : PubMed/NCBI
3	Fernandez F and Garcia HA: Giant dedifferenciated liposarcoma of the spermatic cord. Arch Esp Urol. 62:751–755. 2009.(In Spanish). View Article : Google Scholar : PubMed/NCBI
4	Cariati A, Brignole E, Tonelli E and Filippi M: Giant paratesticular undifferentiated liposarcoma that developed in a long-standing inguinal hernia. Eur J Surg. 168:511–512. 2002. View Article : Google Scholar : PubMed/NCBI
5	Kin T, Kitsukawa S, Shishido T, Maeda Y, Izutani T, Yonese J and Fukui I: Two cases of giant testicular tumor with widespread extension to the spermatic cord: Usefulness of upfront chemotherapy. Hinyokika Kiyo. 45:191–194. 1999.(In Japanese). PubMed/NCBI
6	Martin C, Olivier CM, Rengifo D, Hernandez Lao A, Ondina LM and Carballido J: Giant liposarcoma of the spermatic cord. Actas Urol Esp. 17:361–365. 1993.(In Spanish). PubMed/NCBI
7	Li F, Tian R, Yin C, Dai X, Wang H, Xu N and Guo K: Liposarcoma of the spermatic cord mimicking a left inguinal hernia: A case report and literature review. World J Surg Oncol. 11:182013. View Article : Google Scholar : PubMed/NCBI
8	Alyousef H, Osman EM and Gomha MA: Paratesticular liposarcoma: A case report and review of the literature. Case Rep Urol. 2013:8062892013.PubMed/NCBI
9	Vukmirović F, Zejnilović N and Ivović J: Liposarcoma of the paratesticular tissue and spermatic cord: A case report. Vojnosanit Pregl. 70:693–696. 2013. View Article : Google Scholar : PubMed/NCBI
10	Raza M, Vinay HG, Ali M and Siddesh G: Bilateral paratesticular liposarcoma-a rare case report. J Surg Tech Case Rep. 6:15–17. 2014. View Article : Google Scholar : PubMed/NCBI
11	Vinayagam K, Hosamath V, Honnappa S and Rau AR: Paratesticular liposarcoma-masquerading as a testicular tumour. J Clin Diagn Res. 8:165–166. 2014.PubMed/NCBI
12	García Morúa A, Lozano Salinas JF, Valdés Sepúlveda F, Zapata H and Gómez Guerra LS: Liposarcoma of the espermatic cord: Our experience and review of the literature. Actas Urol Esp. 33:811–815. 2009. View Article : Google Scholar : PubMed/NCBI
13	Noguchi H, Naomoto Y, Haisa M, Yamatsuji T, Shigemitsu K, Uetsuka H, Hamasaki S and Tanaka N: Retroperitoneal liposarcoma presenting a indirect inguinal hernia. Acta Med Okayama. 55:51–54. 2001.PubMed/NCBI
14	Schoonjans C, Servaes D and Bronckaers M: Liposarcoma scroti: A rare paratesticular tumor. Acta Chir Belg. 116:122–125. 2016. View Article : Google Scholar : PubMed/NCBI
15	Fitzgerald S and Maclennan GT: Paratesticular liposarcoma. J Urol. 181:331–332. 2009. View Article : Google Scholar : PubMed/NCBI
16	Gabriele R, Ferrara G, Tarallo MR, Giordano A, De Gori A, Izzo L and Conte M: Recurrence of paratesticular liposarcoma: A case report and review of the literature. World J Surg Oncol. 12:2762014. View Article : Google Scholar : PubMed/NCBI
17	Bostwick DG: Spermatic cord and testicular adnexa. 1997.
18	Fahsi O, Kallat A, Ouazize H, Dergamoun H, Sayegh HE, Iken A, Benslimane L and Nouini Y: Metastatic paratesticular liposarcoma. Pan Afr Med J. 27:1012017. View Article : Google Scholar : PubMed/NCBI
19	Thinyu S and Muttarak M: Role of ultrasonography in diagnosis of scrotal disorders: A review of 110 cases. Biomed Imaging Interv J. 5:e22009. View Article : Google Scholar : PubMed/NCBI
20	Pergel A, Yucel AF, Aydin I, Sahin DA, Gucer H and Kocakusak A: Paratesticular liposarcoma: A radiologic pathologic correlation. J Clin Imaging Sci. 1:572011. View Article : Google Scholar : PubMed/NCBI
21	Yoshino T, Yoneda K and Shirane T: First report of liposarcoma of the spermatic cord after radical prostatectomy for prostate cancer. Anticancer Res. 29:677–680. 2009.PubMed/NCBI
22	Montgomery E and Fisher C: Paratesticular liposarcoma: A clinicopathologic study. Am J Surg Pathol. 27:40–47. 2003. View Article : Google Scholar : PubMed/NCBI
23	Pănuş A, Meşină C, Pleşea IE, Drăgoescu PO, Turcitu N, Maria C and Tomescu PI: Paratesticular liposarcoma of the spermatic cord: A case report and review of the literature. Rom J Morphol Embryol. 56:1153–1157. 2015.PubMed/NCBI
24	Rekhi B, Navale P and Jambhekar NA: Critical histopathological analysis of 25 dedifferentiated liposarcomas, including uncommon variants, reviewed at a Tertiary Cancer Referral Center. Indian J Pathol Microbiol. 55:294–302. 2012. View Article : Google Scholar : PubMed/NCBI
25	McCormick D, Mentzel T, Beham A and Fletcher CD: Dedifferentiated liposarcoma. Clinicopathologic analysis of 32 cases suggesting a better prognostic subgroup among pleomorphic sarcomas. Am J Sur Pathol. 18:1213–1223. 1994. View Article : Google Scholar
26	Coindre JM, Pedeutour F and Aurias A: Well-differentiated and dedifferentiated liposarcomas. Virchows Arch. 456:167–179. 2010. View Article : Google Scholar : PubMed/NCBI
27	Brennan MF, Casper ES, Harrison LB, Shiu MH, Gaynor J and Hajdu SI: The role of multimodality therapy in soft-tissue sarcoma. Ann Surg. 214:328–338. 1991. View Article : Google Scholar : PubMed/NCBI
28	Kanso C, Roussel H, Zerbib M, Flam T, Debré B and Vieillefond A: Spermatic cord sarcoma in adults: Diagnosis and management. Prog Urol. 21:53–58. 2011. View Article : Google Scholar : PubMed/NCBI
29	Sherman KL, Wayne JD, Chung J, Agulnik M, Attar S, Hayes JP, Laskin WB, Peabody TD, Bentrem DJ, Pollock RE and Bilimoria KY: Assessment of multimodality therapy use for extremity sarcoma in the United States. J Surg Oncol. 109:395–404. 2014. View Article : Google Scholar : PubMed/NCBI
30	Khandekar MJ, Raut CP, Hornick JL, Wang Q, Alexander BM and Baldini EH: Paratesticular liposarcoma: Unusual patterns of recurrence and importance of margins. Ann Surg Oncol. 20:2148–2155. 2013. View Article : Google Scholar : PubMed/NCBI
31	Song CH, Chai FY, Saukani MF, Singh H and Jiffre D: Management and prevention of recurrent paratesticular liposarcoma. Malays J Med Sci. 20:95–97. 2013.PubMed/NCBI
32	Cerda T, Martin É, Truc G, Créhange G and Maingon P: Safety and efficacy of intensity-modulated radiotherapy in the management of spermatic cord sarcoma. Cancer Radiother. 21:16–20. 2017. View Article : Google Scholar : PubMed/NCBI
33	Gago Juan A, Luján Galán M, Bustamante Alarma S, Fernández Lobato R, Zárate Rodríguez E, Martín Osés E and Berenguer Sánchez A: A paratesticular myxoid liposarcoma as a simulator of a hernial process. A case report. Arch Esp Urol. 50:921–923. 1997.PubMed/NCBI
34	Stranne J, Hugosson J and Lodding P: Post-radical retropubic prostatectomy inguinal hernia: An analysis of risk factors with special reference to preoperative inguinal hernia morbidity and pelvic lymph node dissection. J Urol. 176:2072–2076. 2006. View Article : Google Scholar : PubMed/NCBI