bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study on neoadjuvant chemoradiotherapy plus nimotuzumab followed by surgery for patients with advanced cervical cancer.
Authors: Lu Heming , Yu Jinming , Wu Yuying , Liu Xu , Jiang Hailan , Peng Luxing , Deng Shan , Qin Jian , Cheng Jinjian , Pang Qiang , Gu Junzhao , Lu Zhiping , Liang Ping , Zhao Renfeng , Chen Changyi , Hu Xiaoxia 
Published: September 2018

e17000 Background: This study was to investigate the efficacy and safety of neoadjuvant chemoradiotherapy plus nimotuzumab followed by surgery for advanced cervical cancer. Methods: The inclusion criteria of this study were as follows: age: 18-75 years old; ECOG 0-1; FIGO stages IB2-IIIB; not eligible for surgery. IMRT with a total dose of 50-54 Gy was delivered to the tumor and the whole uterus, and 45-48.6 Gy to the high-risk regions. Weekly cisplatin or nedaplatin was administered concurrently with IMRT. Weekly nimotuzumab was given for 6 cycles. Patients were then assessed for clinical tumor response and operability. For those who were candidates for surgery, radical hysterectomy and pelvic lymph node dissection were performed 5-6 weeks after the completion of neoadjuvant therapy. Results: Twenty-eight patients were enrolled. Stage distributions were as follows: IB2, 3 pts; IIA, 5 pts; IIB, 16 pts; IIIA, 2 pts; IIIB, 2 pts. Twenty six (92.8%) patients completed ≥ 5 cycles of chemotherapy, and all completed ≥5 cycles of nimotuzumab. Complete clinical response and partial response were found in 8 patients (28.5%) and 20 patients (71.5%), respectively. Four patients were not eligible for surgery and 2 candidates refused surgery. They were not included in this analysis. Radical surgery was performed for the remaining 22 patients. Among them, 8 (36.4%) had complete pathology response, 9 (40.9%) presented with persistent atypical cells or cervical intraepithelial neoplasia, and 5 (22.7%) presented with macroscopic and/or microscopic residual disease. Median follow-up was 22 months (range, 5-39 months). The 2-year locoregional control rate, progression-free survival rate, distant metastasis-free survival rate, and overall survival rate were 95.0%, 85.2%, 84.0%, and 90.0%, respectively. Acute toxicity profiles were mainly manifested as marrow suppression, nausea, diarrhea, and loss of appetite. They were mild in general and easily manageable. Chronic toxicities were mainly limited to grade 1. No severe late toxicities were observed Conclusions: This treatment approach is highly effective and safe in advanced cervical cancer. Further studies are warranted to confirm the findings. Clinical trial information: NCT01938105.
Analysis of short-term efficacy and pathological outcome of paclitaxel plus platinum as neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer.
Authors: He Yue , Wu Yu-Mei , Zhao Qun , Geng Yu-Ning , Yang Shu-Li , Finas Dominique , Yin Cheng-Hong 
Published: September 2018

e17002 Background:The purpose of this study is to observe the short-term efficacy and pathological outcomes of paclitaxel combined with platinum (TP) as neoadjuvant chemotherapy (NACT) regimen in patients with locally advanced cervical cancer (LACC). Methods: This is a prospective study involving 61 women with histologically confirmed LACC referred for NACT at Beijing Obstetrics and Gynecology Hospital between April 2013 and January 2015. Results: The short-term efficacy of NACT was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST). The short-term efficacy of NACT was 91.8% (complete remission and partial remission). The cervical invasion ≤1/2 was 82.4% in the complete remission (CR) group, 46.2% in the partial remission(PR) group and 20% in the stable disease (SD) group. The difference between groups was statistically significant (p=0.012). The slides of all surgical specimens were reviewed and classified according to Tumor Regression Grade (TRG). The good response was defined by good short-term efficacy (RECIST) and the difference between the groups was statistically significant (p=0.042). The short-term efficacy of NACT in artery intervention (AI) group (70-80%) was better than that in intravenous (IV) group (20%-30%) and the difference was statistically significant (p=0.011). The patients with tumor diameter ≤5cm and multiple cycles of chemotherapy have good short-term efficacy of NACT in LACC. All patients were followed up to the last day of 2015 with the median follow-up time of 21.5 months for NACT. For the 61 patients referred for NACT in LACC, two patients had relapsed and 1 patient died from the disease. Conclusions: The study showed that the Paclitaxel plus platinum as NACT for LACC treatment had a significant local effects. It could reduce tumor myometrial invasion and regress tumor. The short-term efficacy of the treatment in the AI group was more effective than in the IV group, two cycles of NACT of AI treatment to LACC patients would obtain an optimal short-term efficacy. Clinical trial information: NCT02471027.
Surgical outcomes of single port lapraroscopic radical hysterectomy in cervical cancer.
Authors: Yoo Ji Geun , Lee Yoon Kyung Elena , Lee Keun Ho 
Published: September 2018

e17003 Background: We aim to see the postoperative outcomes of single port laparoscopic radical hysterectomy in cervical cancer. Methods: Twenty five cervical cancer patients (FIGO stage 9 IA, 13 IB, and 3 IIA) were treated by single port laparoscopic radical hysterectomy in single center. Results: Six patients were performed by type A hysterectomy, 6 by type B, and 13 by type C radical hysterectomy. Median operation time was 91, 197, and 275 minutes, respectively. Median number of pelvic nodes retrieved was 20. There was no postoperative complication except a colon serosa injury in type C radical hysterectomy and which repaired by single port approach. Ten out of 25 patients got an adjuvant radiation therapy and there were 3 recurrences (1 in type A, 2 in type C). Median disease free survival was 9.5 months in type A, 14 months in type C. Conclusions: Single port radical hysterectomy is safe and comparable to conventional laparoscopic hysterectomy in cervical cancer
Expression profile associated with CD274 (PD-L1) expression in cervical cancer.
Authors: Roman Bassaure Edgar , Berumen Campos Jaime , Medina Ingrid Yasbeth 
Published: September 2018

e17005 Background: In Mexico, cervical cancer (CaCU) is the second leading cause of death in women. New treatment strategies are now emerging specifically the pathway of PD-1. We evaluated the frequency of PD-L1 expression at mRNA level and analyzed the expression profiles associated with different levels of CD274 expression. Methods: We analyzed the mRNA of 17 controls and 59 cervical cancer tumors by an expression microarray that allows the analysis of 22,607 human genes. Tumors were classified based on the mRNA expression of CD274. The deregulated genes in each group of tumors were compared against the control group using a T-test and Fold Change value. Functional analysis was using the DAVID tool. Correlation gene analysis was performed using the Pearson test. Results: The 59 cervical cancer tumors were classified in 3 groups: CD274-, CD274 low expression and CD274 high expression. The 71.2% of the tumors of CaCU have CD274 expression, 20 tumors with low expression and 22 tumors with high expression. 786 altered genes in the CD274- group, 1759 in the group of low expression and 2465 in the group of high expression were found. We found 19 altered biological processes in the CD274- group, being the most significant, cell cycle, DNA replication and DNA repair. In the tumors CD274 low were found 20 biological processes altered and were similar to those identified in the CD274- tumors. In the group CD274 high, 28 altered biological processes were found, interestingly 5 biological processes associated with innate immune response and antigenic processing. We found 24 genes correlated with the CD274 expression related to the immune response. Conclusions: The frequency of CD274 expression in cervical cancer is similar to that found in other tumors, it would be interesting explore the correlation between mRNA and protein. The number of altered genes is higher in the group of high expression of CD274. In the CD274 high group genes associated with processes related to the immune response are altered. The genes that correlate with the expression of CD274 are mostly associated with the immune system, these results suggest that overexpression of CD274 is accompanied by other immune processes.
The role of parents awareness to decision on HPV vaccination in Kazakhstan.
Authors: Kaidarova Dilyara , Nasrytdinova Nadejda , Kairbayev Murat 
Published: September 2018

e17008 Background: Despite the proven effectiveness of HPV vaccination against cancer and precancerous lesions the acceptance rates are not perfect. The goal of the study was to look how parents awareness about HPV affected decision to vaccinate their daughters. Methods: The interview was held in schools where first HPV vaccination trial program started. The survey included questions about social and economic status, HPV and HPV vaccine awareness, the source of information on HPV and decision about vaccination. The number of surveyed parents was 357. Correlation statistics and chi-square test have been used with SPSS 19 (IBM corp.). Results: 34.7±2.52% though that HPV vaccine can protect from other STI. There was significant dependability from the country region (p=0.001) and type of urban area (p=0.017). 136 respondents out of 357 agreed to vaccinate their daughters (38.1%±2.6%). The decision to vaccinate depends from age (p=0.006), sex (p= ≤0.001) and family history of cancer (р=0.001). As the main source of information about HPV vaccine parents highlighted gynaecologists (54.0±3.02%), and paediatricians (22.8±2.54%). Most belief that vaccine protects from cancer 65.4±2.46%, whereas 16.8±1.98% trust their medical caregivers. The answers of parents depends from country region (р≤0.001), urban area (р≤0.001), sex (р=0.004), education (р=0.001), religion (р≤0.001) and family history (р≤0.001). Conclusions: The acceptance rate of HPV vaccine in trial is very low, most have doubts regarding the importance of vaccinations. There is a significant room for improvement, HPV and HPV vaccination awareness programs are needed to increase the acceptance rate of the vaccine in Kazakhstan.
Apatinib as a salvage treatment in gynecologic cancer patients failed from two or more lines of prior chemotherapy.
Authors: Xie Congying , Su Meng , Jin Xiance 
Published: September 2018

e17009 Background: The aim of this study was to evaluate the efficacy and safety of apatinib, an oral VEGFR2 inhibitor, in the treatment of advanced cervical and ovarian cancer patients who failed from two or more lines of chemotherapy. Methods: The advanced cervical and ovarian cancer patients, who experienced two or more lines of chemotherapy and treated with apatinib from April 2015 to January 2017, were retrospectively reviewed. All eligible patients received continuous apatinib treatment until disease progression, death, or intolerable toxicity. Survival and toxicities outcome were evaluated by Kaplan-Meier method and according to NCI-CTC4.0. Results: Twenty-six patients were eligible (cervical cancer:12 and ovarian cancer:14). After dose adjustment, 14 patients (53.8%) received 500 mg daily of apatinib, 8 patients received 250mg, 3 received 425mg and 1 received 675mg daily. The median progression-free survival (PFS) of cervical cancer and ovarian cancer were 8 months (95%CI:3.83-12.17) and 4 months (95%CI:1.57-6.44), respectively. Objective response rates in cervical cancer and ovarian cancer were 50% and 50%, respectively. Disease control rates were 100% for cervical cancer and 71.4% for ovarian cancer. Complete response was not observed in either cervical cancer or ovarian cancer. A 52-year old patient with recurrent ovarian cancer, experienced two lines of chemotherapy failure, was orally administered with apatinib at a dose of 250mg daily from November 2015, got partial response (PR) after one month, PFS have not yet reach. A 43-year old female patient with advanced cervical cancer, experienced three lines of chemotherapy failure, was orally administered with apatinib at a dose of 250mg daily from September 2015, got PR with a PFS of 14 months. The toxicities associated with apatinib treatment was generally acceptable with 8 patients developed grade 3/4 toxicity. The most common adverse events in this study were hypertension(n = 17), hand-foot syndrome(n = 24), and mouth mucositis(n = 20). Conclusions: Apatinib monotherapy showed promising efficiency with tolerable toxicity for advanced/recurrent cervical and ovarian cancer patients who failed from two or more lines of chemotherapy.
Impact of cervical cancer care volume on clinical outcomes of laparoscopic radical hysterectomy: A systematic review and meta-analysis.
Authors: Lee Banghyun , KIM Kidong 
Published: September 2018

e17013 Background: This study investigated the impact of hospital and physicain cervical cancer case volume on clinical outcomes of laparoscopic radical hysterectomy (LRH) to clarify the hypothesis that clinical outcome of cervical cancer may depend on experience of hospital and physician performing radical hysterectomy (RH). Methods: In January 2017 the PubMed search identified 556 articles. A combination of the following key words was used in the search: (cervical cancer and laparoscopy and RH) and (cervical cancer and LRH). When filtered for studies presenting operative outcomes and/or perioperative complications of LRH 59 studies including 4,367 patients met the selection criteria: high volume hospitals (HVH) (≥15 cases/year; 13 studies, 2227 patients) and low volume hospitals (LVH) (<15 cases/year; 46 studies, 2140 patients); high volume physicians (HVP) (≥10 cases/year; 7 studies, 1167 patients) and low volume physicians (LVP) (<10 cases/year; 35 studies, 1258 patients). Linear regression analysis which is weighted by the number of patients per year in each study was performed to evaluate differences between the groups using Stata/SE 14. Results: Analyses according to hospital volume showed following outcomes in HVH compared with LVH: tendency of lower operative time and blood loss; the higher number of lymph nodes (LN) retrieved; older age; and lower frequency of stage IA. Moreover, hospital stay, intra- and post-operative complications, adjuvant therapy, 5-year overall survival, disease free survival and recurrence rate, stage IB1, IB2, and IIA, LN metastasis, and lymphovascular space, parametrial and surgical margin invasion were not different between the groups. Analyses according to physician volume showed following outcomes in HVP compared with LVP: the higher number of LN retrieved; longer hospital stay; higher 5-year recurrence rate; and lower frequency of stage IA and surgical margin invasion. Moreover, other factors were not different between the groups. Conclusions: Higher hospital and physician volumes are associated with better operative outcomes. However, those might not be favorable prognostic factors for cervical cancer.
Changes in ovarian hormonal status in cervical cancer patients under the influence of combined HPV/chlamydia trachomatis infection.
Authors: Bandovkina Valeria , Frantsiyants Elena Mikhaylovna , Guskova Nailya , Moiseenko Tatiana , Vovkochina Marina , Cheryarina Natalia D. , Pogorelova Yulia A. , Agarkova Elena I. , Vereskunova Marina I. , Guskova Ekaterina , Avanesova Kristina , Tselishcheva Irina V. , Abakumova Svetlana V. , Golomeeva Nadezhda , Zakharchenko Viktoria , Belgova Svetlana V. , Nozdricheva Anastasia , Gornostaeva Ekaterina 
Published: September 2018

e17019 Background: The purpose of the study was to analyze hormonal disorders in tissues of histologically unchanged ovaries of patients with cervical cancer infected with HPV/Chlamydia trachomatis. Methods: We studied levels of estrone (E1), estradiol (E2), free estriol (E3), free (fT) and total (T) testosterone, progesterone (P4), steroid-binding globulin (SBG) and prolactin (PRL) by the ELISA in intact ovaries of 25 patients aged 53.4±3.2 years with cervical cancer T1b-2aN0M0. HPV presence was determined by Е7 protein expression, Chlamydia trachomatis (Ch. tr.) – by IgG and IgА to Ch. tr. and antigen/DNA by ELISA and Real-time PCR. Tissues of intact ovaries obtained during hysterectomy from 22 non-infected women of similar age with endometrial cancer T1N0M0 were used as the control. Results: The data demonstrated a sharp decrease in E2 level by 9.3 times and increase in E1 by 2.3 times in intact ovaries of cervical cancer patients infected with HPV and Ch. tr., compared with the values in controls. Changes were noted in the balance between some estrogen fractions: E1 percentage increased by 5 times, E3 – by 2.4 times and E2 percentage decreased by 4 times. Androgenic status in intact ovaries in cervical cancer was characterized with increased levels of T (by 5.1 times) and fT (by 1.6 times). We noted an increase in SBG concentration by more than 3 times in response to the release of androgens registered in ovarian tissue, as well as significant (by 4.4 times) increase in PRL and decrease in P4 by 1.5 times compared with non-infected tissues. Estrogens to P4 ratio in co-infected patients reduced by 1.6 times, while the PRL to P4 ratio increased by 6.4 times, mainly due to disorders in hormone-producing ovarian function. Conclusions: The development of malignant process in the cervix in a combined HPV and Chlamydia trachomatis infection is accompanied by disorders of the endocrine status in tissues of intact ovaries and shows the undeniable role of consequences of HPV/Chlamydia trachomatis coinfection in this process.
Influence of chlamydia infection on DNA damage in patients with cervical cancer.
Authors: Guskova Nailya , Goroshinskaya Irina A. , Kit Oleg Ivanovich , Surikova Ekaterina Igorevna , Tarnopolskaya Olga Vladimirovna , Guskova Ekaterina , Golomeeva Nadezhda , Abakumova Svetlana V. , Tselishcheva Irina V. , Avanesova Kristina , Nozdricheva Anastasia , Zakharchenko Viktoria , Belgova Svetlana V. 
Published: September 2018

e17020 Background: The role of Chlamydia trachomatis (Ch. tr.) in development of cervical neoplasia is widely discussed. However, molecular mechanisms of Ch. tr. contribution to carcinogenesis are poorly studied. The purpose of the study was to analyze degrees of DNA damage in blood leucocytes in patients with cervical cancer with Ch. tr. infection and in non-infected patients and healthy women. Methods: DNA damage was assessed by the comet assay, the alkaline single-cell gel electrophoresis (20 min, 300 mA, 20 V, 2 V/cm, 4°C) allowing detection of DNA base modifications leading to alkali-labile sites. The preparations were stained with ethidium bromide solution and microscoped (Axio Imager M2, Zeiss) at the excitation wavelength 520 nm and emission wavelength 640 nm. 200 cells were analyzed in each preparation. Percentage of DNAs in the comet tail (T%DNA) was used as an indicator of DNA damage. DNA damage was assessed in 14 patients with cervical cancer and in 13 healthy women. The data were analyzed using Exsel and Statistika 6.0 programs and Mann-Whitney U test and Student's t-test. Results: Mean T%DNA in 8 cervical cancer patients non-infected with Ch. tr. was 4.35±0.63, being significantly (р=0.012580) higher (by 53.7%) than in women without oncopathology (2.83±0.20). The value in infected patients was 10.44±0.11 which was significantly higher than in non-infected patients (by 2.4 times, р=0.000056) and in healthy women (by 3.7 times, р=0.000000). Thus, presence of Ch. tr. was associated with more than 2 times increase in DNA damage in cervical cancer patients. The results are consistent with previously reported data of cell culture studies according to which chlamydia causes histone modification and DNA double strand breaks [Chumduri C. et al., 2013]. Conclusions: The results confirm the role of chlamydia infection in DNA damage in blood cells in cervical cancer patients which promotes malignant development in organs of the female reproductive system.
Bevacizumab eligibility in patients with metastatic cervical cancer: A retrospective review.
Authors: Skelton William Paul , Markham Merry Jennifer 
Published: September 2018

e17021 Background: Bevacizumab (BEV) is approved for use in combination with chemotherapy for metastatic/recurrent cervical cancer (CC) based on the GOG 240 trial, which showed increased survival and response rates (RR). However, because of its contraindications, use of BEV is not always feasible or safe. The purpose of this study was to identify the percentage of metastatic/recurrent CC patients at our institution who would have been eligible to receive BEV according to eligibility criteria from GOG 240. Methods: A retrospective study was conducted to identify metastatic CC patients treated at UFHealth between 2006-2016. Chart review was performed to determine their kidney, liver, and bone marrow function, ECOG performance status (PS), presence of an active bleeding condition or nonhealing wound, or inadequately treated venous thromboembolism. Data analysis was performed to determine if the patient would have been eligible to receive BEV based on eligibility criteria from GOG 240. Results: We identified 62 patients with metastatic CC treated at UFHealth between 2006-2016: 1 patient was excluded due to insufficient data. 55 patients (90.2%) would have been ineligible to receive BEV based on the GOG 240 exclusion criteria, and 6 patients (9.8%) would have been eligible. The most common reason for exclusion from BEV use was active bleeding (45 of 61 pts: 73.8%); 42 of the 45 with bleeding (93.3%) had vaginal bleeding. 18 of 61 (29.5%) would be excluded due to poor PS, 17 of 61 (27.9%) due to poor renal function, and 13 of 61 (21.3%) due to an inadequately anticoagulated thromboembolism. Conclusions: Despite the improved survival and higher RR associated with BEV use in combination with chemotherapy, only 9.8% of metastatic CC patients treated at UFHealth over a ten year period would have been eligible to receive BEV. Most patients would have been excluded due to active bleeding, most commonly vaginal bleeding. Though clinical trial data supports the use of BEV with chemo, many patients are simply not eligible due to complications from their disease. Identifying novel therapies for metastatic/recurrent CC patients with improved safety profiles that would allow for their use in this challenging population is critical.