By Sheldon A. Weiner (auth.), Earl A. Surwit M.D., David S. Alberts M.D. (eds.)

Cytological screening for the id of intraepithelial neoplasia of the cervix as a precursor lesion for cervical melanoma has been good proven as an efficient potential for lowering the prevalence of invasive carcinoma. regardless of those screening efforts, carcinoma of the cervix continues to be one of many extra universal malignancies in ladies and it's the best reason behind melanoma dying in lots of international locations within the western hemisphere. it's expected that during 1986 there'll nonetheless be 14,000 new instances of invasive melanoma, with 6,800 deaths within the usa on my own. regrettably, a lot of those sufferers current with complicated ailment, posing tricky administration difficulties for the clinician chargeable for their care. The therapy of early level invasive carcinoma of the cervix (lesions limited to the cervix and vagina) is still both radical surgical procedure, radical radiation treatment or a mixture thereof This procedure is awfully potent within the overwhelming majority of sufferers. despite the fact that, there is still a subset of sufferers with early degree illness which are at excessive possibility for recurrence. Dr Kjorstad (Chapter 2) has pointed out adenocarcinomas and adenosqua­ mous carcinomas as having a very bad analysis. furthermore, sufferers with greater than 3 optimistic lymph nodes or with involvement of lymph nodes open air of the pelvis have a truly bad analysis. He has iden­ tified the CEA as a most likely predictive marker for those sufferers with negative analysis, particularly in sufferers with adenocarcinomas.

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Whether the added radiotherapy is really indicated and enhances the chances of cure, is obscure [15]. The prognostic importance of pelvic lymph node dissemination is pronounced as 50% of these patients will die from their disease, but the extent of the dissemination and the localization of the metastases are of paramount importance. The reported incidence of pelvic lymph node mestastasis in operable patients varies from 10 to 30%. The reason for this is that different selective criteria are used in different centers.

05) (Figure 2) [10]. -c > > .... 6 ::J c - ~ I', b. • ,~ ~ b \ .... 4 '0 , PR-'0, Q. 0 a.. -. -J 40 Months Figure 1. Proportion of primary cervical cancer patients surviving in months grouped according to receptor status in 39 patients. Source: Gao, Twiggs, Leung et al. [10]. 6 0 '- 0 a. 4 0 '- a. 2 20 10 40 30 Months Figure 2. Proportion of postmenopausal cervical cancer patients surviving in months grouped according to progesterone receptor status in 19 patients. Source: Gao, Twiggs, Leung et al.

1982. Value of tumor antigen (TA-4) of squamous cell carcinoma in predicting the extent of cervical cancer. Cancer 50: 1294. 35. Gold P, Freedman SO. 1965. Specific carcinoembryonic antigens of the human digestive system. J Exp Med 122:467. 36. Khoo SK, Mackay EV. 1973. Carcinoembryonic antigen in cancer of the female reproductive system: Sequential levels and etTect of treatment. Aust N Z Obstet Gynecol 3: 1. 37. van Nagell JR, Donaldson ES, Gay EC et al. 1979. Carcinoembryonic antigen in carcinoma of the uterine cervix: Tissue localization and correlation with plasma antigen concentration.

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Cervix Cancer by Sheldon A. Weiner (auth.), Earl A. Surwit M.D., David S.
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