Micrometastases in Sentinel Lymph Nodes Represent a Significant Negative Prognostic Factor in Early-Stage Cervical Cancer: A Single-Institutional Retrospective Cohort Study

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2020 Jun 4

PMID 32486512

Citations 10

Authors

Roman Kocian

Jiri Slama

Daniela Fischerova

Anna Germanova

Andrea Burgetova

Ladislav Dusek

Pavel Dundr

Kristyna Nemejcova

Jiri Jarkovsky

Silvie Sebestova

Filip Fruhauf

Lukas Dostalek

Tereza Ballaschova

David Cibula

Affiliations

Soon will be listed here.

Abstract

The data on the prognostic significance of low volume metastases in lymph nodes (LN) are inconsistent. The aim of this study was to retrospectively analyze the outcome of a large group of patients treated with sentinel lymph node (SLN) biopsy at a single referral center. Patients with cervical cancer, stage T1a-T2b, common tumor types, negative LN on preoperative staging, treated by primary surgery between 01/2007 and 12/2016, with at least unilateral SLN detection were included. Patients with abandoned radical surgery due to intraoperative SLN positivity detected by frozen section were excluded. All SLNs were postoperatively processed by an intensive protocol for pathological ultrastaging. Altogether, 226 patients were analyzed. Positive LN were detected in 38 (17%) cases; macrometastases (MAC), micrometastases (MIC), isolated tumor cells (ITC) in 14, 16, and 8 patients. With the median follow-up of 65 months, 22 recurrences occurred. Disease-free survival (DFS) reached 90% in the whole group, 93% in LN-negative cases, 89% in cases with MAC, 69% with MIC, and 87% with ITC. The presence of MIC in SLN was associated with significantly decreased DFS and OS. Patients with MIC and MAC should be managed similarly, and SLN ultrastaging should become an integral part of the management of patients with early-stage cervical cancer.

Citing Articles

Low-Volume Metastases in Cervical Cancer: Does Size Matter?.

Bianchi T, Grassi T, Di Martino G, Negri S, Trezzi G, Fruscio R Cancers (Basel). 2024; 16(6).

PMID: 38539442 PMC: 10969161. DOI: 10.3390/cancers16061107.

Predictors of Non-Sentinel Lymph Node Metastasis in Patients with Positive Sentinel Lymph Node in Early-Stage Cervical Cancer: A SENTICOL GROUP Study.

Pache B, Tantari M, Guani B, Mathevet P, Magaud L, Lecuru F Cancers (Basel). 2023; 15(19).

PMID: 37835431 PMC: 10571801. DOI: 10.3390/cancers15194737.

MILACC study: could undetected lymph node micrometastases have impacted recurrence rate in the LACC trial?.

Nitecki R, Ramirez P, Dundr P, Nemejcova K, Ribeiro R, Vieira Gomes M Int J Gynecol Cancer. 2023; 33(11):1684-1689.

PMID: 37652529 PMC: 11781375. DOI: 10.1136/ijgc-2023-004711.

Therapies in Cervical Cancer-Editorial.

Naik R, Wood N, Anagnostopoulos A, Yiannakis D Cancers (Basel). 2023; 15(2).

PMID: 36672486 PMC: 9856916. DOI: 10.3390/cancers15020537.

[Carbon nanoparticle tracing of sentinel lymph nodes in diagnosis and treatment of cervical cancer and clinical value of lymph node ultrastaging detection].

Lin X, He J, Lu J, Huang C, Liu N Nan Fang Yi Ke Da Xue Xue Bao. 2023; 42(12):1896-1901.

PMID: 36651260 PMC: 9878409. DOI: 10.12122/j.issn.1673-4254.2022.12.20.

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