Nidia Gomez Rueda

Lymph node metastases in carcinoma of the cervix uteri: Response to neoadjuvant chemotherapy and its impact on survival

One hundred and sixty-nine patients with squamous cancer of the cervix uteri treated with three courses of neoadjuvant chemotherapy with the modified VBP scheme are presented. All were subjected to a Wertheim-Meigs operation with paraaortic lymph-adenectomy. The incidence of lymph node metastases is analyzed according to clinical stage, tumor volume, residual tumor in the surgical specimen, and clinical response to neoadjuvant chemotherapy. A significant decrease in the incidence of lymph node involvement was observed in good responders. Survival rates, after 2 years of follow-up, improved in those cases with small residual tumor, negative parametria, and negative nodes.

Results of a Phase II trial with neoadjuvant chemotherapy in carcinoma of the cervix uteri

Results of a Phase II trial with neoadjuvant chemotherapy in carcinoma of the cervix uteri (VBP modified scheme) show that 85.7% of patients given this therapy were NED in Stage IIb versus 54% of a nonrandomized control group given conventional therapy. In Stage IIIb the averages are 66.6% vs. 31% in the control group. Analysis of the ecographic data has shown that if a critical prechemotherapy volume (120 cm3) is exceeded, the prognosis is unfavorable, especially in cases treated with radiotherapy as second-line treatment.

Vulvar infection caused by human papilloma virus in children and adolescents without sexual contact

Abstract We studied the indirect transmission of human papilloma virus (HPV) to young children and adolescents who were proven, by in-depth sexual history and gynecological examination, never to have had sexual intercourse. Two groups were identified: group A, daughters and sisters (age less than 18 years) of 31 adults with HPV genital lesions (n = 40); group B, 10 virginal girls and adolescents with HPV vulvar lesions and the adult household members were studied for the HPV infection (n = 26). Evaluations included PAP smear, colposcopy, vaginoscopy, and vulvoscopy in the adult female; peneoscopy and biopsy in males; vulvoscopy and cytologic studies (labia minora, vaginal washing) in all minors. A biopsy was obtained from all lesions. Vulvoscopic findings consistent with HPV were found in 75% of the group A girls. In 83% of those, the biopsy was positive. In group 2, 90% were found to live in a household with at least one positive adult (previously undetected). One or more of the following practices were discovered in the majority of cases: occasional bed sharing, and joint use of towels, bathing suits, underwear, and tub bath. Postdefecation hygiene was carried out in the family bidet. This supports the hypothesis that HPV can be nonsexually transmitted.

Is subradical surgical treatment for carcinoma of the cervix uteri stage IB logical

Twenty-eight patients with squamous carcinoma of the cervix FIGO stage Ib were treated with three courses of neoadjuvant chemotherapy with a VBP modified scheme. Clinical responses showed that the percentage of complete and moderate responses exceeds 95% of the cases. Clinical response was also related to tumor bulk measurement by ultrasound scanning. Twenty-three of the patients were then subjected to the Wertheim-Meigs operation. Pathological findings of surgical specimens showed absence of residual lesion in 6 patients (26.1%) and carcinoma smaller than 0.5 cm in 5 patients (21.7%). Tumor response to neoadjuvant chemotherapy was excellent in NG3, MG3 tumors when lymphoplasmomonocytic infiltration was present. In accord with this result a new protocol was developed.