• Title/Summary/Keyword: Uterine cervix

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Results of Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 방사선치료 성적)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.359-368
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    • 1995
  • Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

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Postoperative Radiotherapy for the Early Stage Carcinoma of the Uterine Cervix (초기 자궁경부암의 수술후 방사선 치료)

  • Kim, Jin-Hee;Kim, Ok-Bge;Lee, Tae-Sung
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.337-346
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    • 1993
  • This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

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Uterine Torsion Associated with Hydrometra and Pyometra in a Domestic Rabbit (애완 토끼에서 자궁수종, 자궁축농증, 자궁염전의 병발 증례)

  • Na, Sanggi;Choi, Jihye
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.544-546
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    • 2014
  • A 1.5-year-old, female domestic rabbit was diagnosed with uterine torsion accompanying hydrometra of the right uterine horn and pyometra of the left horn. The exploratory laparotomy revealed the torsion of bilateral uterine horns in the region of the uterine cervix. No growth was detected in fluid collected from the right horn of the uterus; however, Gram-positive micrococcus and bacilli were cultured from the left horn. The pathophysiology of the simultaneous occurrence of these disorders was suspected considering that abdominal distension progressed over 4 months and the rabbit's condition deteriorated abruptly within 2 days, hydrometra was the initial disease and then infection to the left uterine horn and torsion developed later due to the large volume of fluid within the uterus. This report is the first case showing uterine torsion accompanying hydrometra and pyometra in each uterine horn.

Uterine Involution and Ovarian Follicular Growth during Early Postpartum Period of Murrah Buffaloes (Bubalus bubalis)

  • Lohan, I.S.;Malik, R.K.;Kaker, M.L.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.3
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    • pp.313-316
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    • 2004
  • Ultrasonographic studies were conducted on eight Murrah buffaloes daily from day 6 postpartum (pp) onwards till day 77 pp to monitor changes in the cervix, uterine horn and ovarian follicular growth and development. The mean size of horn and cervix on day six ($9.07{\pm}0.74$ and $8.58{\pm}0.00cm$) decreased significantly to $4.09{\pm}0.09$ and $3.56{\pm}0.08cm$ by day 27 pp, respectively. Follicles in 50% of the buffaloes ovulated within 24 to 54 days pp and the size of the largest follicle on different days increased to more than 5 mm. The remaining 50 percent of animals ovulated after 65 days postpartum. Large size follicles (>8.5 mm) appeared in six out of eight buffaloes between 10 to 30 days pp and five animals had ovulated during early postpartum period. Waves pattern of follicular growth was observed during early postpartum period. Ovulatory follicles growth rate was more than the anovulatory follicles and increase in size was more as compared to the subordinate follicle. Anovulatory follicles persisted for longer period. Mean size of large follicle was more from day 6 to 41 pp and again from 50 to 65 pp in cyclic animals. Second large follicle were large during early postpartum (18days), thereafter, its size was more in acyclic animals. Small follicles population was less in cyclic animals upto day 50 postpartum. Mean medium size follicle growth pattern did not differ in cyclic and acyclic groups. Large size follicle number was more in cyclic group (5/8) during 14 to 20 days postpartum. Presence of large follicles (>8.5 mm) showed initiation of ovarian activity.

A Study on the Insertional Coil of MRI Device for Diagnosis (진단용 자기공명영상장치의 삽입 코일에 관한 연구)

  • Lee, Yong-Moon;Lim, Keun-Ho;Seo, Dae-Keon;Kim, Wang-Gon;Hong, Jin-Woong
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2003.05d
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    • pp.33-37
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    • 2003
  • Endovaginal and endorectal receiver only surface coil were designed for MR imaging(MRI) and $^1H$ MR spectroscopy(MRS) for the uterine cervix and the prostate. The shape of endovaginal coil wire was rectangular with round comer. The shape of endorectal coil wire was long elliptic shape during insertion and circular shape after insertion. Conventional spin echo and fast spin echo sequences were used as T1 and T2 weighted imaging sequences, respectively. 3D volume localized in vivo $^1H$ MR spectroscopy of the human cervix and prostate was performed using PRESS or STEAM localization method. Using home-built endvaginal and endorectal coils, excellent T1 and T2 images were obtained to visualize early cervical and prostate tumors. 3D volume localized in vivo $^1H$ MRS was useful to differentiate the cancerous tissue from the normal tissue.

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Does Microinvasive Adenocarcinoma of Cervix Have Poorer Treatment Outcomes than Microinvasive Squamous Cell Carcinoma?

  • Ruengkhachorn, Irene;Hanamornroongruang, Suchanan;Leelaphatanadit, Chairat;Sangkarat, Suthi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4013-4017
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    • 2016
  • Background: To compare the pathological findings and oncologic outcomes of stage IA cervical carcinoma patients, between adenocarcinoma and squamous cell carcinoma cases. Materials and Methods: A total of 151 medical records of stage IA cervical carcinoma patients undergoing primary surgical treatment during 2006-2013 were reviewed. Information from pathological diagnosis and recurrence rates were compared with descriptive statistical analysis. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis. Results: The median age was 48.9 years. There was no significant difference in rates of lymph node, parametrium, uterine, vaginal, or ovarian metastasis, when comparing adenocarcinoma with squamous cell carcinoma. Overall recurrence rates of adenocarcinoma (5.7%) and squamous cell carcinoma (2.6%) were not statistically significant different, even when stratified by stage. When comparing progression free survival with squamous cell carcinoma, adenocarcinoma had an HR of 0.448 (0.073-2.746), p=0.386. Conclusions: Microinvasive adenocarcinoma of cervix has similar rate of extracervical involvement and oncologic outcomes to squamous cell carcinoma.

An Unusual Case of Extra-Enteric Blastocystosis in the Uterine Cervix

  • Escutia-Guzman, Yolanda;Martinez-Flores, Williams Arony;Martinez-Ocana, Joel;Martinez-Pimentel, Ramon;Benitez-Ramirez, Marisol;Martinez-Hernandez, Fernando;Arroyo-Escalante, Sara;Romero-Valdovinos, Mirza;Orozco-Mosqueda, Guadalupe Erendira;Maravilla, Pablo
    • Parasites, Hosts and Diseases
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    • v.58 no.5
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    • pp.571-576
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    • 2020
  • Extra-enteric infections by Blastocystis spp. have rarely been documented. Here, we report a case of extra-enteric blastocystosis in a patient with minimal cervicitis symptoms. A 47-year-old Hispanic female patient was attended in a primary health centre in Michoacan state, Mexico, for her routine gynaecological medical examination. As only symptom, she referred to a slight vaginal itching. The presence of several vacuolar-stages of Blastocystis spp. were identified by Papanicolaou staining; molecular identification was attempted by culture-PCR sequencing of a region of 18S gene from cervical and faecal samples obtained 2 months after cytological examination, even when patient declared that she tried self-medicating with vaginal ovules. Blastocystis ST1 was identified only in the faecal sample. The presence of Blastocystis spp. in the cervix of a patient with scarce symptomatology, demonstrates the extraordinary flexibility of this microorganism to adapt to new environments and niches.

Reasons for Variation in Sensitivity and Specificity of Visual Inspection with Acetic Acid (VIA) for the Detection of Pre-Cancer and Cancer Lesions of Uterine Cervix

  • Parashari, Aditya;Singh, Veena
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7761-7762
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    • 2013
  • Alternative strategies such as visual inspection of cervix with acetic acid, are real time, economical and easily implemented methods for cervical cancer screening. However, variable sensitivity and specificity have been observed in various community based studies. The possible reasons could include variation in man power training, light source used for visualization, and preparation of diluted (4-5%) acetic acid and its storage. A standardized protocol for training, teaching material (easy to understand in the local language) for trainees, supervision and reinforcement by intermittent and supplementary training to check the quality of their observation, a standard protocol for preparation dilute acetic acid and its storage and a standard good light source (equivalent to day light) are needed to minimize the variation in sensitivity and specificity of VIA in community settings.

Endometrial Polyps with Open-Cervix Pyometra in a Cat

  • Lee, Sang-Ho;Park, Chul-Ho;Son, Chang-Ho
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.222-225
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    • 2018
  • The current study describes a case of endometrial polyps accompanied by an open-cervix pyometra in a 15-year-old female Chinchilla Persian cat. The cat was presented with a history of a large mass in the endometrium and purulent discharge from the vulva. Ovariohysterectomy was performed and pedunculated polypoid mass on the endometrium was seen protruded into the uterine cavity. Histologically, the mass was composed of multiple cystically dilated glands surrounded by fibrous stroma. Based on gross and histologic findings, the diagnosis for this case was concluded.

Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea (한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구)

  • Choi Doo Ho;Kim Eun Seog;Kim Yong Ho;Kim Jin Hee;Yang Dae Sik;Kang Seung Hee;Wu Hong Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.61-70
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    • 2005
  • Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.