Role of neo-adjuvant chemotherapy followed by surgery in cervical cancer: a review

Incidence of cervical cancer is predominantly found in developing countries. In Indian set up, it is most commonly found in rural locations in younger population. Chemotherapy was initially introduced for the treatment of recurrent/metastatic cervix cancer and has subsequently been explored in primary treatment either as neo-adjuvant prior to radiation or surgery in an attempt to reduce the incidence of loco-regional recurrence. The review study tries to evaluate the role of neoadjuvant chemotherapy (NACT) followed by surgery in cervical cancer management. Randomized trials and meta-analysis were analysed. Most of them used short course chemotherapy course of 4-6 weeks followed by surgery. patients with high risk pathological features received postoperative RT. The results of trials indicated significant reduction in the risk of death with NACT, but there were few differences between the trials. NACT followed by surgery is found to be associated with an improved response rate and progression-free survival. However, the impact on overall survival remains to be confirmed.

Incidence of thrombophilia in patients with recurrent pregnancy loss

Background: Approximately 1-3% of women of reproductive age suffer from recurrent pregnancy loss. Objective of this study was to evaluate the association between recurrent pregnancy loss and thrombophilia.Methods: This is a descriptive study, involving retrospective analysis of patients with recurrent pregnancy losses. Patients with recurrent pregnancy loss in whom associated morbidity factors were excluded underwent screening for both acquired and inherited thrombophilia.Results: A total of 20 patients were screened for acquired and inherited thrombophilia with recurrent pregnancy loss. Thrombophilia was diagnosed in 70% cases. Out of which, anticardiolipin antibodies was found positive in 57% of patients, protein C 7% and protein S deficiency was observed in 35% cases.Conclusions: Thrombophilias are associated with recurrent pregnancy loss. Patients in whom other associated morbid factors are excluded, should be offered screening for thrombophilia. Multidisciplinary management involving hematologist is vital for management.