Increased diversity of a cervical microbiome associates with cervical cancer.

The cervical microbiome (CM) is a complex ecosystem that can change in response to gynecological cancers. We aimed to evaluate changes in the CM of patients who underwent chemoradiation (CRT) therapy for locally advanced cervical cancer. Before and after CRT, cervical swab samples were collected from 16 patients with squamous cell carcinoma of the cervix, and 30 healthy women. All samples were subjected to 16s rRNA-Seq analysis. In healthy premenopausal women the CM comprised mostly Lactobacillus (>90%); the CM community in samples from both pre- and postmenopausal pre-treatment cancer patients was heterogeneous, with a low proportion of Lactobacillus in younger cases. On the genus level, 27 and 11 taxa differentiated healthy controls from cancer patients in pre- and postmenopausal age groups, while 31 and 2 genera differentiated pre- and post-radiation samples and pre-radiation and the follow-up samples, respectively. Microbiome diversity was significantly higher in pre-treatment patients than in healthy controls. The results reveal significant alterations in the CM of cervical cancer patients relative to that in healthy controls; these changes were more striking after CRT. However, further research is needed to determine whether alteration of the CM offers new therapeutic options.

[Prognostic value of histopathology in cervical cancer patients]. / Rokownicze znaczenie utkania histopatologicznego u chorych na raka szyjki macicy.

UNLABELLED: Cervical cancer is the sixth cause of cancer morbidity and the seventh cause of cancer death among women in Poland. The rising tendency of cervical adenocarcinoma morbidity and the decrease of cervical squamous cell carcinoma have been observed. Many authors emphasize the worse outcome of cervical adenocarcinoma patients, when compared with the squamous cell cancer. OBJECTIVES: The assessment of prognostic value of histopathology in cervical cancer patients. MATERIAL AND METHODS: The retrospective analysis of 142 cervical adenocarcinoma and 242 squamous cell cancer patients, treated between January 1989 and December 1999, at Gynecological Oncology Department of Maria Sklodowska-Curie Memorial Cancer Center in Warsaw, has been performed, In each case, the clinical diagnosis was histologically confirmed. All patients were treated with surgery and/or radiotherapy The above methods were used as the routine therapeutic modalities, during the analyzed period. The analysis of the overall survival (OS) and the disease-free survival (DFS), in dependence on the selected clinico-pathological factors, was performed. RESULTS: The percentage of the 5-year OS for cervical adenocarcinoma patients amounted to 45.0%, whereas for squamous cell cancer to 62.5%. The difference was statistically significant (p = 0.05). In spite of higher percentage of cervical adenocarcinoma, diagnosed at early stage, when compared with squamous cell cancer the outcome of the whole adenocarcinoma group was worse. CONCLUSIONS: Regardless of the other clinico-pathological factors, adenocarcinoma was associated with poorer survival Identification of women who are at risk and different treatment modalities for both types of tumor should be the subject of future studies.

[Survival of cervical cancer patients in selected regions of Poland in 1990-1996, in relation to some prognostic factors]. / Ocena przezyc chorych na raka szyjki macicy w wybranych rejonach Polski w latach 1990-1996 z uwzglednieniem niektórych czynników rokowniczych.

To evaluate whether cervical cancer patients in selected regions of Poland show similar 5-year survival rates and if they are different from European average and, also, to evaluate the effect of selected prognostic factors. The analysis based on a cohort of 1386 cervical cancer cases identified by population-based Cancer Registries collecting data from Kieleckie and Opolskie voivodships and from the City of Warsaw in 1990-96. These data become complete by adding information from medical records. The 5-year relative survival rates were calculated using the life tables method, and, a multivariant regression analysis was applied for evaluation of prognostic factors. The regions differed significantly in stage distribution (p<0.001), however, they were similar in age groups and histological diagnosis. The age-standardized relative 5-year overall survival rate was 52.2%, and was among lowest rates in Europe. The rate in Kieleckie was 60.7%; in Opolskie--43.3%, and in Warsaw--51.9%. The rates for Stage I in those regions were comparable at over 80%, but were different for Stage II and higher stages. The multivariant analysis showed a significant risk increase related to stage advancement (p<0.0001) as well as to the place of living in Opolskie (p=0.02) and to the adenocarcinoma diagnosis (p=0.05). However, the analysis did not confirm the effect of age of diagnosis as a prognostic factor. The overall, age-standardised 5-year relative survival rates of cervical cancer patients are one of the lowest in Europe, though diversified in the regions. They are almost satisfactory and close to European average in Kieleckie where prevention was effective, but poor in the other regions. The low survivals overall are basically due to the unsatisfactory proportion of the early stage of disease. The uneven survivals of patients with Stage II and higher stages of cancer in the selected regions of Poland suggest different standards of treatment.

[Hydronephrosis as a prognostic factor for patients of figo IIIB cervical cancer]. / Zastój moczu jako czynnik prognostyczny u chorych na raka szyjki macicy w IIIB stopniu klinicznego zaawansowania.

OBJECTIVE: The aim of this study was to assess whether hydronephrosis is a prognostic factor for patients of FIGO stage III B cervical cancer. MATERIAL AND METHODS: A retrospective review of 145 stage III B cervical cancer patients treated with radiotherapy between 1989-1993 at Maria Sklodowska-Curie Memorial Cancer Center in Warsaw was performed. Radiotherapy consisted of External Beam Irradiation (EBI) and Brachytherapy (BT) or EBI alone. RESULTS: Multivariate analysis revealed that hydronephrosis and Brachytherapy following EBI as the second part of the treatment were statistically significant factors in survival of FIGO stage III B cervical cancer patients. The five-year survival rate was 36% for patients without hydronephrosis treated with EBI and BT, compared to the group with hydronephrosis treated with EBI alone (no regression or too slow regression of the tumor to use BT), in which the survival rate was only 17 months. CONCLUSION: FIGO III b cervical cancer patients with hydronephrosis are treated only with palliative intent.