Class III NSRH: Oncological outcome in 170 cervical cancer patients

Tumor-associated Schwann cells as new therapeutic target in non-neurological cancers

Cancer neuroscience, a burgeoning field, investigates the complex interactions between cancer and the nervous system, emphasizing how cancer cells exploit neuronal components for growth and metastasis. Tumor-associated Schwann cells (TASc) have emerged as crucial players in the progression of highly innervated cancers, highlighting the intricate relationship between the tumor microenvironment (TME) and the nervous system. This review concludes how TASc, as the most abundant glial cell in the peripheral nervous system, contribute to tumor growth, metastasis, and the remodeling of the TME. Acting similarly to reactive astrocytes in the central nervous system, TASc are implicated in driving perineural invasion (PNI), a distinctive cancer progression pathway facilitating tumor infiltration and metastasis. These TASc not only contribute indirectly to pain but also promote tumor recurrence and poor prognosis. Intrinsic to their role, TASc exhibit unique gene expression profiles and phenotypic transformations, shifting from myelinating to non-myelinating states, thereby actively participating in metastasis and the remodeling of the tumor microenvironment. Targeting TASc represents a novel and promising therapeutic strategy in non-neurological cancers, offering new avenues for clinical intervention.

Bulky mesonephric adenocarcinoma of the uterine cervix treated with neoadjuvant chemotherapy and radical surgery: report of the first case

AIMS AND BACKGROUND

Malignant mesonephric adenocarcinoma of the uterine cervix is a rare occurrence with few cases described in the literature. Although surgery seems to be effective in the treatment of early-stage tumor, no cases describing outcomes of locally advanced stage are available.

METHODS

We report the first case of a patient with International Federation of Obstetrics and Gynecologists stage IIB mesonephric adenocarcinoma undergoing neoadjuvant chemotherapy and radical surgery.

CONCLUSIONS

Despite the inherent limitation of a single description of a case, our experience supports the utilization of neoadjuvant chemotherapy in patients with malignant mesonephric adenocarcinoma of the uterine cervix. Further prospective multi-institutional studies are needed.

Short and long-term urodynamic and quality of life assessment after nerve sparing radical hysterectomy: a prospective pilot study

OBJECTIVE

The aim of this study was to compare pre- and postoperative bladder function and quality of life (QoL) in women diagnosed with gynecologic malignancy and treated with nerve sparing radical hysterectomy (NSRH).

STUDY DESIGN

Before and after NSRH for uterine malignancy, bladder function was prospectively assessed in a small cohort of 12 women (39-72 years) suffering from uterine malignancy using urodynamic studies and a validated self-administered condition specific QoL questionnaire. Urodynamic studies were performed one day before (U0) as well as one week (U1) and 22 months (U2) after surgery. The questionnaire was applied at U0 and U2.

RESULTS

Cystometry showed detrusor contractions leading to overactive bladder incontinence in six out of nine women at short-term, which persisted in three women at long-term follow-up leading to a significant impaired QoL. Voiding function and bladder sensation remained uncompromised after surgery.

CONCLUSIONS

NSRH preserves voiding function and bladder sensation. However, short and long-term urodynamic detrusor overactivity and urge incontinence was observed in a significant number of women although symptoms improved over time. These data are important for counselling women and for the design of larger studies to assess the benefits of NSRH versus conventional radical hysterectomy (RH).

Unintended consequences: surgical complications in gynecologic cancer

More than 91,000 women in the USA will be diagnosed with a gynecologic malignancy in 2013. Most will undergo surgery for staging, treatment or both. No therapeutic intervention is without consequence, therefore, it is imperative to understand the possible complications associated with the perioperative period before undertaking surgery. Complication rates are affected by a patient population that is increasingly older, more obese and more medically complicated. Surgical modalities consist of abdominal, vaginal, laparoscopic and robotic-assisted approaches, and also affect rates of complications. An understanding of the various approaches, patient characteristics and surgeon experience allow for individualized decision-making to minimize the complications after surgery for gynecologic cancer.

Local control after tailored surgical treatment of early cervical cancer

BACKGROUND

It was the aim of our study to analyze oncological outcome and prognostic parameters in patients with early stages cervical cancer after tailored and well-standardized surgical treatment with an adequate follow-up.

METHODS

Oncological outcome and prognostic parameters were evaluated in a group of 192 patients with cervical cancer stages IA2 to 2B who had undergone radical hysterectomy (n = 171), radical parametrectomy (n = 12), or radical trachelectomy (n = 9). Procedures were classified as type B (n = 72), type C1 nerve sparing (n = 103), or type C2 (n = 17).

RESULTS

Event-free and overall 5-year survivals probabilities reached 92.7% (confidence interval, 89.5%-95.9 %) and 94.1% (confidence interval, 90.9%-97.3 %). There was only 1 isolated pelvic recurrence found of the total of 10 recurrences. Adjuvant radiotherapy was given to only 22% of patients. The most significant independent prognostic parameters in stage IB tumors were lymph node status, histological type, and tumor volume, whereas in stage II, the parameters included histological type and tumor volume, the latter being inversely related to the prognosis.

CONCLUSIONS

We have shown an excellent prognosis, especially local control, after tailored surgical treatment of stages IA2 to IIB of cervical cancer, with low prevalence of adjuvant treatment. Different prognostic parameters were observed for stages IB1/IB2 and IIA/B.