Skip to main content
SpringerLink
Log in

Treatment patterns and survival outcomes in patients with cervical cancer complicated by complete uterine prolapse: a systematic review of literature

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Cervical cancer complicated by complete uterine prolapse is a rare clinical entity and uniform management recommendations have yet to be determined. The aim of the current review was to examine the effects of management patterns on survival outcomes in cervical cancer patients with complete uterine prolapse.

Methods

A systematic review of the literature was conducted using three public search engines. This included case reports with detailed descriptions of tumor characteristics, cancer management, and survival outcomes. Treatment patterns and tumor characteristics were correlated to survival outcomes.

Results

There were 78 patients with cervical cancer with complete uterine prolapse. Their mean age was 63.7 years. The median duration of prolapse was 147.9 months and 22.2 % of the patients experienced persistent/recurrent prolapse after cancer treatment. The mean tumor size was 8.9 cm and squamous cell carcinoma (83.9 %) was the most common histologic type. The majority of patients (56.2 %) had stage I cancer. Tumor characteristics were similar across the treatment patterns. Survival outcomes were more favorable with surgery-based treatment (48 patients) than with radiation-based treatment (30 patients): 5-year recurrence-free survival rate 72.0 % vs. 62.9 % (p = 0.057), and 5-year disease-specific overall survival rate 77.0 % vs. 68.2 % (p = 0.017). After controlling for age and stage, surgery-based therapy remained an independent prognostic factor for better disease-specific overall survival outcome (hazard ratio 0.32, 95 % confidence interval 0.11 – 0.94, adjusted p = 0.039).

Conclusions

Although limited in study size, our results at least suggest that surgery-based treatment may have a positive effect on survival outcome in cervical cancer patients with complete uterine prolapse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  2. Maher C, Feiner B, Baessler K, Schmid C (2013) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4, CD004014

    PubMed  Google Scholar 

  3. Richter HE, Varner ER (2007) Pelvic organ prolapse. In: Berek JS (ed) Berek and Novak's gynecology, vol 24. Lippincott Williams and Wilkins, Philadelphia, pp 897–934

    Google Scholar 

  4. Swift S, Woodman P, O'Boyle A, Kahn M, Valley M, Bland D et al (2005) Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol 192:795–806

    Article  PubMed  Google Scholar 

  5. Edwards EA, Beebe RA (1950) Carcinoma of the cervix in association with procidentia. Q Bull Northwest Univ Med Sch 24:12

    PubMed  CAS  PubMed Central  Google Scholar 

  6. Mehboob R, Ahmad N (2002) Unexpected pathology at vaginal hysterectomy for genital prolapse. Pak J Med Res 41:1–5

    Google Scholar 

  7. Loizzi V, Cormio G, Selvaggi L, Carriero C, Putignano G (2010) Locally advanced cervical cancer associated with complete uterine prolapse. Eur J Cancer Care (Engl) 19:548–550

    Article  CAS  Google Scholar 

  8. da Silva BB, da Costa AR, Filho CP, Melo JA (2002) Carcinoma of the cervix in association with uterine prolapse. Gynecol Oncol 84:349–350

    Article  PubMed  Google Scholar 

  9. Cabrera S, Franco-Camps S, Garcia A, Verges R, Diaz-Feijoo B, Perez-Benavente MA et al (2010) Total laparoscopic radical hysterectomy for cervical cancer in prolapsed uterus. Arch Gynecol Obstet 282:63–67

    Article  PubMed  Google Scholar 

  10. de Lima OA (1952) Cervical cancer and prolapse of the uterus. Obstet Gynecol Surv 7:849–850

    Article  Google Scholar 

  11. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  PubMed  CAS  Google Scholar 

  12. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  13. Beecham CT (1980) Classification of vaginal relaxation. Am J Obstet Gynecol 136:957–958

    PubMed  CAS  Google Scholar 

  14. Baden WF, Walker TA (1972) Genesis of the vaginal profile: a correlated classification of vaginal relaxation. Clin Obstet Gynecol 15:1048–1054

    Article  PubMed  CAS  Google Scholar 

  15. Chen GD, Ng CS (2007) Updated definition of female pelvic organ prolapse. Incont Pelvic Floor Dysfunct 1:121–124

    Google Scholar 

  16. Ashton DL (1948) Carcinoma of the cervix complicating procidentia uteri. Am J Obstet Gynecol 55:299–302

    PubMed  CAS  Google Scholar 

  17. Cabaniss CM, Crocker CL (1963) Carcinoma of the prolapsed cervical stump. Report of a case. Obstet Gynecol 22:606–9

    PubMed  CAS  Google Scholar 

  18. Calame RJ, Perticucci S, de Fazio L (1970) Multiple primary carcinoma of the uterus: a review. Obstet Gynecol Surv 25:191–206

    Article  PubMed  CAS  Google Scholar 

  19. Chambers CB (1975) Uterine prolapse with incarceration. Am J Obstet Gynecol 122:459–462

    PubMed  CAS  Google Scholar 

  20. Dane B, Dane C, Erginbas M, Baran S, Cetin A (2009) Verrucous carcinoma of the cervix in a case with uterine prolapse. Ann Diagn Pathol 13:344–346

    Article  PubMed  Google Scholar 

  21. Daw E (1972) Carcinoma of cervix in association with procidentia. Br J Clin Pract 26:197–200

    PubMed  CAS  Google Scholar 

  22. Diaz-Bazan N (1964) Cervical carcinoma with procidentia in El Salvador: report of 10 cases with review of the literature. Obstet Gynecol 23:281–288

    PubMed  CAS  Google Scholar 

  23. Guthrie D, Bache W (1932) The Infrequency of carcinoma of the cervix with complete procidentia. Ann Surg 96:796–800

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  24. Hesselberg E (1963) Cancer of the cervix associated with procidentia. S Afr Med J 37:589–592

    PubMed  CAS  Google Scholar 

  25. Kistner RW (1957) Cervical carcinoma complicating procidentia; report of a case. Obstet Gynecol 10:482–6

    PubMed  CAS  Google Scholar 

  26. Kriplani A, Relan S, Kumar L, Biswal BM, Rath GK (1995) Incarcerated procidentia: a rare complication of carcinoma cervix. Aust N Z J Obstet Gynaecol 35:463–464

    Article  PubMed  CAS  Google Scholar 

  27. Reimer D, Sztankay A, Steppan I, Abfalter E, Lunzer H, Marth C et al (2008) Cervical cancer associated with genital prolapse – a brief review of the literature and long-term results of successful treatment with radiochemotherapy and surgery in a very frail patient. Eur J Gynaecol Oncol 29:272–275

    PubMed  CAS  Google Scholar 

  28. Rocker I (1958) Malignant changes in procidentia; the incidence during the years 1949-54 at Addenbrooke's Hospital, Cambridge. J Obstet Gynaecol Br Emp 65:89–91

    Article  PubMed  CAS  Google Scholar 

  29. Sholes DM Jr (1959) Carcinoma of the cervix and uterine prolapse. Obstet Gynecol 13:223–225

    Article  PubMed  Google Scholar 

  30. Stone BH, Mansell H (1955) Procidentia and cervical cancer. Obstet Gynecol 5:198–200

    PubMed  CAS  Google Scholar 

  31. Todd TF (1937) Two cases of carcinoma of the cervix complicating procidentia uteri. Proc R Soc Med (Section of Obstetrics and Gynaecology) 30:1343–1344

    Google Scholar 

  32. Wong WS, Ng CS, Lee CK (1990) Verrucous carcinoma of the cervix. Arch Gynecol Obstet 247:47–51

    Article  PubMed  CAS  Google Scholar 

  33. Graham JB, Sotto LSJ, Paloucek FP (1962) Carcinoma of the cervix, vol 12. WB Saunders Company, Philadelphia, pp 231–239

    Google Scholar 

  34. Du XL, Tao J, Sheng XG, Lu CH, Yu H, Wang C et al (2012) Intensity-modulated radiation therapy for advanced cervical cancer: a comparison of dosimetric and clinical outcomes with conventional radiotherapy. Gynecol Oncol 125:151–7

    Article  PubMed  Google Scholar 

  35. Quinn MA, Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT et al (2006) Carcinoma of the cervix uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 95 (Suppl 1):S43–S103

    Article  PubMed  Google Scholar 

  36. Harvey RA, Ritchie RN (1943) Carcinoma of the cervix complicated by complete procidentia: radiation therapy. Radiology 41:48–51

    Article  Google Scholar 

  37. Way S (1958) Perineal anterior exenteration. Br J Obstet Gynaecol 65:24–27

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Drs. Katherine E. Tierney, MD, Kodama Michiko, MD, PhD, and Mikio Mikami, MD, PhD, for scientific input and technical support for this study.

Conflicts of interest

None.

Funding support

None.

Authors’ contributions

K. Matsuo: study concept, data collection and analysis, manuscript writing

M.E. Fullerton: data collection, manuscript writing

A. Moeini: data interpretation, manuscript writing

All authors significantly contributed to the study and approved the final version of manuscript.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Los Angeles County Medical Center, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA

    Koji Matsuo, Morgan E. Fullerton & Aida Moeini

  2. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA

    Koji Matsuo

Authors
  1. Koji Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Morgan E. Fullerton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aida Moeini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Koji Matsuo.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 222 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Matsuo, K., Fullerton, M.E. & Moeini, A. Treatment patterns and survival outcomes in patients with cervical cancer complicated by complete uterine prolapse: a systematic review of literature. Int Urogynecol J 27, 29–38 (2016). https://doi.org/10.1007/s00192-015-2731-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-015-2731-8

Keywords

Search

Navigation