Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2018; 39(03): 282-286
DOI: 10.4103/ijmpo.ijmpo_152_16
Original Article

Role of Histopathological Differentiation as a Prognostic Factor for Treatment Response in Locally Advanced Squamous Cell Carcinoma Cervix Patients

Afsana Shah
Department of Radiation Oncology, Delhi State Cancer Institutes, New Delhi, India
,
Nihar Kanta Jena
Department of Radiation Oncology, Delhi State Cancer Institutes, New Delhi, India
,
Pragya Shukla
Department of Radiation Oncology, Delhi State Cancer Institutes, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
   Permissions and Reprints

Abstract

Introduction: The aim of the study was to evaluate the prognostic significance of histopathological differentiation in treatment outcome of locally advanced carcinoma cervix. Materials and Methods: This retrospective study includes 167 patients of locally advanced carcinoma cervix treated between January 2006 and December 2008 who have received definitive chemoradiation. Results:: The number of patients with well (85 [50.9%]) and moderately differentiated (76 [45.5%]) carcinoma was nearly equal with poorly differentiated variety having only 6 (3.6%) patients. On completion of treatment out of the 167 patients, 133 (79.6%) had a complete response and 34 (20.4%) had residual disease. On mean follow-up of 11 months, 19 (14.2%) patients had local and 5 (3.7%) had a distant relapse. Histopathological differentiation and age had no association with treatment outcome, whereas early-stage disease showed trend favoring better treatment response. Conclusion: Advanced stage along with poor histopathological differentiation influences the aggressiveness of the tumor responsible for distant relapse. However, histopathological differentiation has no correlation with local treatment response and overall survival. The main factor influencing the treatment outcome is the intrinsic radiosensitivity of the tumor and volume of the disease.

Keywords

Carcinoma cervix - histopathological differentiation - intrinsic radiosensitivity - prognostic factor - treatment outcome


Publication History

Article published online:
17 June 2021

© 2018. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1. 2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [internet]. Lyon, France: International Agency for Research on Cancer, 2010 Available form: http://globocan.iarc.fr
  • 2 Brady LW, Plenk HP, Hanley JA, Glassburn JR, Kramer S, Parker RG. et al. Hyperbaric oxygen therapy for carcinoma of the cervix – Stages IIB, IIIA, IIIB and IVA: Results of a randomized study by the radiation therapy oncology group. Int J Radiat Oncol Biol Phys 1981; 7: 991-8
    CrossrefPubMedGoogle Scholar
  • 3 Hornback NB, Shupe RF, Shidnia H, Marshall RN, Tamara Lauer RN Advanced stage 3B cancer of the cervix treatment by hyperthermia and radiation. Gynecol Oncol 1986; 23: 160-7
    CrossrefPubMedGoogle Scholar
  • 4 Bosch FX, Lorincz A, Muñoz N, Meijer CJ, Shah KV The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55: 244-65
    CrossrefPubMedGoogle Scholar
  • 5 Sevin BU, Nadji M, Lampe B, Lu Y, Hilsenbeck S, Koechli OR. et al. Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer 1995; 76: 1978-86
    CrossrefPubMedGoogle Scholar
  • 6 Kamura T, Tsukamoto N, Tsuruchi N, Saito T, Matsuyama T, Akazawa K. et al. Multivariate analysis of the histopathologic prognostic factors of cervical cancer in patients undergoing radical hysterectomy. Cancer 1992; 69: 181-6
    CrossrefPubMedGoogle Scholar
  • 7 Meanwell CA, Kelly KA, Wilson S, Roginski C, Woodman C, Griffiths R, et al. Young age as a prognostic factor in cervical cancer: Analysis of population based data from 10,022 cases. Br Med J (Clin Res Ed) 1988;296:386-91.
  • 8 Wheeler JA, Stephens LC, Tornos C, Eifel PJ, Ang KK, Milas L. et al. ASTRO Research Fellowship: Apoptosis as a predictor of tumor response to radiation in Stage IB cervical carcinoma. American Society for Therapeutic Radiology and Oncology. Int J Radiat Oncol Biol Phys 1995; 32: 1487-93
    CrossrefPubMedGoogle Scholar
  • 9 Haensgen G, Krause U, Becker A, Stadler P, Lautenschlaeger C, Wohlrab W. et al. Tumor hypoxia, p53, and prognosis in cervical cancers. Int J Radiat Oncol Biol Phys 2001; 50: 865-72
    CrossrefPubMedGoogle Scholar
  • 10 Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000; 100: 57-70
    CrossrefPubMedGoogle Scholar
  • 11 World Health Organization. International Histological Classification of Tumors. Vol. 1-25. Geneva: World Health Organization; 1978.
  • 12 Hardt N, van Nagell JR, Hanson M, Donaldson E, Yoneda J, Maruyama Y. et al Radiation-induced tumor regression as a prognostic factor in patients with invasive cervical cancer. Cancer 1982; 49: 35-9
    CrossrefPubMedGoogle Scholar
  • 13 Janot F, Klijanienko J, Russo A, Mamet JP, de Braud F, El-Naggar AK. et al Prognostic value of clinicopathological parameters in head and neck squamous cell carcinoma: A prospective analysis. Br J Cancer 1996; 73: 531-8
    CrossrefPubMedGoogle Scholar
  • 14 Reagan JW, Fu YS. Histologic types and prognosis of cancers of the uterine cervix. Int J Radiat Oncol Biol Phys 1979; 5: 1015-20
    CrossrefPubMedGoogle Scholar
  • 15 Crissman JD, Budhraja M, Aron BS, Cummings G. Histopathologic prognostic factors in stage II and III squamous cell carcinoma of the uterine cervix An evaluation of 91 patients treated primarily with radiation therapy. Int J Gynecol Pathol 1987; 6: 97-103
    CrossrefPubMedGoogle Scholar
  • 16 West CM, Davidson SE, Burt PA, Hunter RD. The intrinsic radiosensitivity of cervical carcinoma: Correlations with clinical data. Int J Radiat Oncol Biol Phys 1995; 31: 841-6
    CrossrefPubMedGoogle Scholar
  • 17 West CM, Davidson SE, Roberts SA, Hunter RD. Intrinsic radiosensitivity and prediction of patient response to radiotherapy for carcinoma of the cervix. Br J Cancer 1993; 68: 819-23
    CrossrefPubMedGoogle Scholar
  • 18 Hong JH, Chen MS, Lin FJ, Tang SG. Prognostic assessment of tumor regression after external irradiation for cervical cancer. Int J Radiat Oncol Biol Phys 1992; 22: 913-7
    CrossrefPubMedGoogle Scholar
  • 19 Marcial VA, Bosch A. Radiation-induced tumor regression in carcinoma of the uterine cervix: Prognostic significance. Am J Roentgenol Radium Ther Nucl Med 1970; 108: 113-23
    CrossrefPubMedGoogle Scholar