ABSTRACT
Cervical cancer remains a leading cause of mortality among women worldwide, particularly in developing nations. While radical surgery is the established standard of care for early-stage disease, pelvic relapse post-surgery remains a concern. Neoadjuvant chemotherapy (NACT) preceding radical surgery has emerged as a promising approach, aiming to reduce tumor burden and improve surgical outcomes. We present three cases of stage 1B3 cervical cancer treated with three cycles of NACT repeated three weekly followed by radical hysterectomy. Post-operatively two patients received radiotherapy (External beam radiotherapy and brachytherapy) and one patient got lost to follow-up for 6 months and did not receive post-operative radiotherapy now under observation and regular follow-up. All the patients exhibited significant tumor reduction following chemotherapy, enabling successful surgical intervention. All patients remained in remission post-treatment. NACT showed effectiveness in reducing tumor size and facilitating successful radical surgery in patients with stage 1B3 cervical cancer. Our case series highlights the potential of NACT followed by radical surgery as a promising therapeutic strategy for stage 1B3 cervical cancer. NACT facilitated successful surgical intervention with favourable outcomes. Further research is warranted to elucidate the optimal patient selection criteria and the long-term benefits of this approach in improving survival rates and quality of life for cervical cancer patients.
ABSTRACT
Global calls for cervical cancer elimination prompt urgent focus on low-income countries where screening challenges persist. While high-income nations utilize advanced methods like human papillomavirus (HPV) testing and colposcopy, many low-resource settings rely on cost-effective approaches like visual assessment with acetic acid (VIA) performed on the same day as screening and treatment. This review explores the feasibility of implementing improved visual assessment methods in low and middle-income countries (LMICs), considering challenges posed by systemic factors. Emphasizing the vital role of visual inspection, particularly in high-income countries where colposcopy guides biopsies and treatment decisions, the article advocates for tailored screening pathways. Unlike extensive multi-step processes in high-income countries, LMICs face limitations in clinic visits, making simple VIA crucial. The article evaluates the potential of cervical imaging devices for low-resource settings, aiming to enhance cervical cancer screening in line with global elimination goals.
ABSTRACT
Mucinous ovarian cancer (MOC) represents a rare subtype within the spectrum of epithelial ovarian carcinoma (EOC). In contrast to a uniform approach applied to all EOC subtypes, MOC stands out as a distinctive entity. A nuanced understanding of the pathological features and genomic profile of MOC holds the potential for enhancing management strategies and, consequently, prognostic outcomes. The differentiation between primary MOC and metastatic mucinous carcinoma poses a challenge but is imperative for accurate clinical decision-making. Notably, early-stage MOC exhibits a favourable prognosis, while advanced disease is characterized by a less favourable outcome. Surgical intervention assumes a pivotal role both in the early stages and metastatic scenarios. Chemotherapy is typically initiated from stage II MOC onwards, with the conventional gynaecological protocol commonly employed; however, there is also precedent for the application of gastrointestinal (GI) regimens. Given the association of MOC with diverse molecular alterations, the consideration of targeted therapy emerges as a potential therapeutic avenue for this unique disease entity. The main tool used for this literature review was PubMed. MOC stands as a distinct entity within EOC subtypes, distinguished from GI mucinous carcinoma by its unique clinical behavior, pathological features, molecular profile, prognosis, and response to standard treatment. The challenges lie in both the diagnosis and treatment of MOC, emphasizing the complexity and specialized considerations required for managing this particular subtype of OC.