ABSTRACT
Background@#The impact of para-aortic lymphadenectomy (PALD) on prognosis and quality of life (QoL) for IB2-IIA2 cervical cancer patients remain controversial. And whether intraoperative frozen pathology exam on common iliac lymph nodes could help predict para-aortic lymph node (PALN) metastasis was unanswered with high-level evidence. @*Methods@#A multi-center, randomized controlled study is intended to investigate the effect of PALD on the prognosis and QoL in cervical cancer patients and to assess the value of intraoperative frozen pathological evaluation of common iliac nodes metastasis for the prediction of PALN metastasis. After choosing whether to receive intraoperative frozen pathological examination of bilateral common iliac lymph nodes, eligible patients will be randomly assigned (1:1) to receive PALD or not. The primary end point is 2-year progression-free survival (PFS). The secondary end points include 5-year PFS, 2-year overall survival (OS), 5-year OS, adverse events (AEs) caused by PALD, AEs caused by radiotherapy and QoL. A total of 728 patients will be enrolled from 8 hospitals in China within 3-year period and followed up for 5 years.
ABSTRACT
Background@#At present, clinical dilemma remains to be solved in terms of therapy-choices for specific locally advanced cervical cancer (LACC) patients: 1) Although concurrent chemoradiotherapy (CCRT) is recommended as the first choice for them, many patients, influenced by the Chinese culture, prefer to choose radical surgery (RS) as their primary treatment. The difference between the 2 therapies in improving patient prognosis is still unknown. 2) Laparoscopy has been questioned since the noted Laparoscopic Approach to Cervical Cancer trial. Nevertheless, clinical research on laparoscopic surgery under the strict tumor-free principle is still underway globally, therefore whether laparoscopic surgery can be used for specific LACC is also an urgent issue to be explored. @*Methods@#A multi-center, randomized controlled study is designed to investigate the effect of different treatment strategies on the prognosis and quality of life (QoL) in patients with specific locally LACC. A total of 402 patients will be enrolled over a period of 3 years. Eligible patients will be randomized (3:1) to either RS group or CCRT group. Patients assigned to RS group will be randomized (1:2) to the abdominal RS group or laparoscopic RS group. All patients will then be followed-up for 5 years. The primary end point is the 2-year progression-free survival (PFS). The secondary end points include 5-year PFS, 2-year overall survival (OS), 5-year OS, adverse events caused by RS or CCRT and QoL.
ABSTRACT
Objective To explore the clinical value of transvaginal color Doppler ultrasound(TV-CDS)in the detection of blood flow changes within the ovarian stromal artery in patients with ovarian endometriosis.Methods Blood flow indices within the ovarian stromal artery were measured by TV-CDS in 60 patients and60 normal controls.Results In ovarian endometriosis group,TV-CDS examination showed the color signal pattern was dot-like with high-resistance ovarian stromal arterial flow which manifested significant higher resistance index(RI),pulsatility index(PI)and systolic/diastolic(S/D)ratio than those in normal group(P<0.01).Analysis on clinicopathologic data showed that cystic history and diameter were risk factors affecting the absence of ovarian stromal blood signal,while cystic history,diameter and category were associated with the significant difference of blood flow display area(P<0.05).Conclusions TV-CDS can be used as a non-invasive,convenient and sensitive method for assessing blood flow changes within the ovarian stromal artery,indicating ovarian interstitial damage as well as pathological conditions of ovarian endometriosis that contributes to clinical diagnosis and treatment.