EP-1316: Value of imaging modalities in predicting pelvic lymph node metastases for uterine cervical cancer

Abstract Backgroud: Extended-field concurrent chemoradiation therapy (Ex-CCRT) is widely used for para-aortic lymph node (PAN) metastasis confirmed by radiographic assessment without surgical assessment. The objective of this prospective study was to evaluate the clinical value of laparoscopic retroperitoneal PAN biopsy in locally advanced cervical cancer (LACC) with pelvic lymph node metastases.Methods: From May 2017 to March 2020, patients with stage IIB-IIIB cervical cancer, who were diagnosed with pelvic node metastasis using positron emission tomography-computed tomography (PET-CT) with SUVmax ≥ 2.0, underwent laparoscopic retroperitoneal PAN biopsy. The radiation fields were extended to the PAN area with pathological metastases.Results: Fourteen patients were diagnosed with squamous cell carcinoma of the cervix at FIGO stage IIB (n=7) and IIIB (n=7). The median operating time was 138 (range, 104–184) minutes. The median number of harvested PANs was 19 (range, 6–36). Three patients were diagnosed as positive for PAN metastasis by histological analysis. In this study, the sensitivity and specificity of PET-CT were 66.7% and 90.9%, respectively.Conclisions: The results of this study revealed that laparoscopic retroperitoneal PAN should be the standard treatment method worldwide because it is not appropriate to determine the radiation field of PAN by image examination without performing a histological assessment.

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The disease stage-associated imbalance of Th1/Th2 and Th17/Treg in uterine cervical cancer patients and their recovery with the reduction of tumor burden

10.21203/rs.2.13442/v2 ◽

2020 ◽

Author(s):

Wei Lin ◽

Hua-ling Zhang ◽

Zhao-yuan Niu ◽

Zhen Wang ◽

Yan Kong ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Tumor Size ◽

Flow Cytometric Analysis ◽

Treg Cells ◽

Hpv Infection ◽

Uterine Cervical Cancer ◽

Disease Stage ◽

Node Metastases

Abstract Background Nearly all uterine cervical cancer (UCC) cases result from human papillomavirus (HPV) infection. After high-risk HPV infection, most HPV infections are naturally cleared by humoral and cell-mediated immune responses. Thus, cervical lesions of only few patients progress into cervical cancer via cervical intraepithelial neoplasia (CIN) and lead to persistent oncogenic HPV infection. This suggests that immunoregulation plays an instrumental role in the carcinogenesis. However, there was a few study on the relation between the immunologic dissonance and clinical characteristics of UCC patients. Method We examined the related immune cells (Th1, Th2, Th17, and Treg cells) by flow cytometric analysis and analyzed their relations with UCC stages, tumor size, differentiation, histology type, lymph node metastases, and vasoinvasion. Next, we quantified the Th1, Th2, Th17, and Treg cells before and after the operation both in UCC and CIN patients. Results When compared with stage I patients, decreased levels of circulating Th1 cells and elevated levels of Th2, Th17, and Treg cells were detected in stage II patients. In addition, the imbalance of Th1/Th2 and Th17/Treg cells was related to the tumor size, lymph node metastases, and vasoinvasion. We found that immunological cell levels normalized after the operations. In general, immunological cell levels in CIN patients normalized sooner than in UCC patients. Conclusions Our findings suggested that peripheral immunological cell levels reflect the patient’s condition.

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Role of 18F-FDG PET/CT in detecting pelvic lymph-node metastases in patients with early-stage uterine cervical cancer

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000000198 ◽

2014 ◽

Vol 35 (12) ◽

pp. 1204-1211 ◽

Cited By ~ 21

Author(s):

Kuan Lv ◽

Hui-min Guo ◽

Ying-jv Lu ◽

Zhi-xing Wu ◽

Ke Zhang ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Early Stage ◽

Uterine Cervical Cancer ◽

Pet Ct ◽

Node Metastases ◽

18F Fdg ◽

Fdg Pet Ct

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REAL-TIME MRI GUIDED IMRT BOOSTING FOR PELVIC LYMPH NODE METASTASES IN CERVICAL CANCER PATIENTS

Radiotherapy and Oncology ◽

10.1016/s0167-8140(12)73047-5 ◽

2009 ◽

Vol 92 ◽

pp. S175

Author(s):

L. Dijkstra ◽

E. Kerkhof ◽

B. Raaymakers ◽

I.M. Jürgenliemk-Schulz ◽

J. Lagendijk

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Real Time ◽

Cancer Patients ◽

Lymph Node Metastases ◽

Pelvic Lymph Node ◽

Node Metastases ◽

Mri Guided

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Frequency of Pelvic Lymph Node Metastases and Parametrial Involvement in Stage IA2 Cervical Cancer: A Population-Based Study and Literature Review

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e318197f3ef ◽

2009 ◽

Vol 19 (1) ◽

pp. 21-26 ◽

Cited By ~ 30

Author(s):

Hannah van Meurs ◽

Otto Visser ◽

Marrije R. Buist ◽

Fibo J.W. ten Kate ◽

Jacobus van der Velden

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Lymph Node Metastases ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Node Dissection ◽

Vascular Space ◽

Parametrial Involvement ◽

Node Metastases

Background:The frequency of lymph node metastases in stage IA2 cervical cancer is reported to range from 0% to 9.7%. Treatment recommendations vary likewise from a cone biopsy to a Wertheim radical hysterectomy and pelvic lymph node dissection. The objective of this study was to get insight into the true frequency of lymph node metastases and/or parametrial involvement in stage IA2 cervical cancer.Methods:The hospital records of 48 patients with stage IA2 cervical carcinoma who registered from 1994 to 2006 were reviewed, and a literature search was performed.Results:Of 48 registered patients, 14 were confirmed to have stage IA2. No lymph node metastases or parametrial invasion and recurrences were found. The collated literature data showed a risk of lymph node metastases of 4.8% (range, 0%-9.7%). The presence of adenocarcinoma and the absence of lymph vascular space invasion resulted in a low risk on lymph node metastases (0.3% and 1.3%, respectively). Parametrial involvement has not been reported.Conclusions:The risk of the selected patients with stage IA2 cervical cancer on lymph node metastases is low. In patients with stage IA2 squamous cell cancer with lymph vascular space invasion, a standard pelvic lymph node dissection should be recommended. Parametrectomy should be included if the nodes are positive. In the other patients, the treatment can be individualized and does not have to include lymph node dissection or parametrectomy.

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