scholarly journals Clinical effects of cervical conization with positive margins in cervical cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yukari Nagao ◽  
Akira Yokoi ◽  
Kosuke Yoshida ◽  
Masanori Sumi ◽  
Masato Yoshihara ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Disease Progression ◽  
Radical Surgery ◽  
Pelvic Lymph Node ◽  
Positive Margins ◽  
Node Metastasis ◽  
Significant Difference ◽  
Cervical Conization

AbstractRadical surgery after cervical conization is a common approach for the treatment of cervical cancer. In some cases, disease progression is observed after positive margins at conization, but the effect of conization on disease progression remains unclear. Thus, the aim of this study was to investigate the clinical outcomes of positive margins at conization in cervical cancer. A total of 101 patients who underwent cervical conization before radical hysterectomy and pelvic lymph node dissection were considered eligible by reviewing medical records. The association between the positive margins and patient outcomes, including subsequent lymph node metastasis, was evaluated. The rate of lymphovascular space invasion (LVSI) positivity at radical surgery was significantly higher in patients with positive margins (p = 0.017) than in those with negative margins, although there was no significant difference in the rate of pelvic lymph node metastasis (p = 0.155). Moreover, there was no significant difference in the overall survival or progression-free survival between the two groups (p = 0.332 and 0.200, respectively). A positive margin at conization presented no significant prognostic disadvantage; thus, diagnostic conization is one of the most suitable treatment options for early-stage cervical cancer that is difficult to accurately assess.

scholarly journals Effect of Cervical Conization with Positive Margins on Lymph Node Metastasis in Cervical Cancer

2021 ◽  
Author(s):  
Yukari Nagao ◽  
Akira Yokoi ◽  
Kosuke Yoshida ◽  
Masanori Sumi ◽  
Masato Yoshihara ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Pelvic Lymph Node ◽  
Positive Margins ◽  
Node Metastasis ◽  
Significant Difference ◽  
Cervical Conization

Abstract Radical surgery after cervical conization is a common approach for the treatment of cervical cancer. Clinically, rapid disease progression is sometimes observed in patients with positive margins at conization, but the details are unclear. This study aimed to investigate the clinical impact of positive margins at conization in cervical cancer. The medical records of patients with cervical cancer between 2010 and 2020 were reviewed retrospectively and we identified 101 eligible patients who underwent radical hysterectomy, including pelvic lymph node dissection. The association between the positive margins of the conization samples and outcomes, including subsequent lymph node metastasis, was evaluated. The rate of lymphovascular space invasion positivity at radical surgery was significantly higher in patients with positive margins (p = 0.017) than in those with negative margins, although there was no significant difference in the rate of pelvic lymph node metastasis (p = 0.155). Moreover, Kaplan–Meier curves showed that there were no significant difference in overall survival or progression-free survival between the two groups (p = 0.332 and p = 0.200, respectively). A positive margin at conization presented no significant prognostic disadvantage, and therefore, diagnostic conization is one of the reasonable options for locally advanced cervical cancer.

scholarly journals Comparison of Postoperative Adjuvant Chemotherapy and Concurrent Chemoradiotherapy for FIGO2018 Stage IIIC1 Cervical Cancer: A Retrospective Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 548
Author(s):  
Masahiro Kagabu ◽  
Takayuki Nagasawa ◽  
Shunsuke Tatsuki ◽  
Yasuko Fukagawa ◽  
Hidetoshi Tomabechi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Metastasis ◽  
Radical Hysterectomy ◽  
Concurrent Chemoradiotherapy ◽  
Postoperative Adjuvant Chemotherapy ◽  
Node Metastasis ◽  
Significant Difference ◽  
Advanced Stages

Background and Objectives: In October 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its classification of advanced stages of cervical cancer. The main points of the classification are as follows: stage IIIC is newly established; pelvic lymph node metastasis is stage IIIC1; and para-aortic lymph node metastasis is stage IIIC2. Currently, in Japan, radical hysterectomy is performed in advanced stages IA2 to IIB of FIGO2014, and concurrent chemoradiotherapy (CCRT) is recommended for patients with positive lymph nodes. However, the efficacy of CCRT is not always satisfactory. The aim of this study was to compare postoperative adjuvant chemotherapy (CT) and postoperative CCRT in stage IIIC1 patients. Materials and Methods: Of the 40 patients who had undergone a radical hysterectomy at Iwate Medical University between January 2011 and December 2016 and were pathologically diagnosed as having positive pelvic lymph nodes, 21 patients in the adjuvant CT group and 19 patients in the postoperative CCRT group were compared. Results: The 5 year survival rates were 77.9% in the CT group and 74.7% in the CCRT group, with no significant difference. There was no significant difference in overall survival or progression-free survival between the two groups. There was no significant difference between CT and CCRT in postoperative adjuvant therapy in the new classification IIIC1 stage. Conclusions: The results of the prospective Japanese Gynecologic Oncology Group (JGOG) 1082 study are pending, but the present results suggest that CT may be a treatment option in rural areas where radiotherapy facilities are limited.

Basement Membranes in Cervical Cancer: Relationship to Pelvic Lymph Node Metastasis and Prognosis

1995 ◽  
Vol 57 (3) ◽  
pp. 351-355 ◽  
Author(s):  
G.L. Bremer ◽  
A.T.M.G. Tiebosch ◽  
H.W.H.M. van der Putten ◽  
J. de Haan ◽  
J.W. Arends
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Basement Membranes ◽  
Pelvic Lymph Node ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

scholarly journals Expression of Fas Ligand is Higher in Early Stage Cervical Cancer with Lymph Nodes Metastasis

2016 ◽  
Author(s):  
Yahya Irwanto
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Hysterectomy ◽  
Fas Ligand ◽  
Pelvic Lymph Node ◽  
Lymph Nodes Metastasis ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis ◽  
Spearman Test

Objective: To know whether the expression of Fas Ligand has correlation with incidene of metastasis of pelvic lymph node and lymph-vascular stromal invasion (LVSI). Methods: All patients diagnosed of cervical cancer stage IB or IIA who underwent radical hysterectomy in Dr. Cipto Mangunkusumo Central General Hospital from January 2008 until December 2009 were included in analytic cross sectional study. We tested expression of Fas Ligand in cervical cancer specimen by immunohystochemistry with monoclonal antibody. The expression of Fas Ligand was compared between the group of patients with a positive and negative pelvic lymph node and between LVSI positive and negative. The difference of expression in both group were statistically analized with Chi-square test and the correlation Spearman test. Result: Ninety one patients underwent radical hysterectomy for two years and 43 patients were included in these study. The expression of Fas Ligand in 7 patients (16.3%) were negative and the others were positive, with weak, moderate and strong expression were 4 (9.3%), 27 (62.8%), and 5 (11.6%) respectively. The expression of Fas Ligand was significantly higher in the group of patients with positive pelvic lymph node compared to the group of the patients with negative pelvic lymph node (p=0.007) but there was no significant difference between group of the patients with LVSI positive and negative. With Spearman test, we found that the expression of Fas Ligand had a strong correlation with pelvic lymph nodes metastasis (coeff. correlation=0.519 and p=0.00) and have no correlation with LVSI (coef. corellation=0.112 and p=0.474). Conclusion: These finding suggested that expression of Fas Ligand in cervical cancer patients has a strong correlation with the incidence of pelvic lymph node metastasis and none with LVSI. [Indones J Obstet Gynecol 2012; 36-4: 194-9] Keywords: cervical cancer, fas ligand, immunohystochemistry, LVSI, pelvic lymph node metastasis

scholarly journals Analysis of clinical and pathological factors in patients undergoing surgery for rectal cancer: a single-centre experience with 692 patients in China

2020 ◽  
Author(s):  
Liping Xu ◽  
Chi Zhang ◽  
Zhaoyue Zhang ◽  
Xinyu Tang ◽  
Qin Qin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Perineural Invasion ◽  
Radical Surgery ◽  
Node Metastasis ◽  
T Stage ◽  
Significant Difference ◽  
Tumour Location ◽  
Poorly Differentiated

Abstract Background: The management of rectal carcinoma has substantially evolved over the past two decades, so as AJCC staging and NCCN guidelines. The inherent relationships of pathologic factors warrant further study. The present study aimed to assess the associations of clinical and pathological factors in rectal cancer patients undergoing radical surgery.Methods: From October 2015 to February 2019, all rectal cancer patients treated with radical surgery without neoadjuvant therapy were identified. The analysis was performed with data obtained from the prospectively collected database. Predictive factors for lymph node metastasis were analysed.Results: In total, 692 patients with a median age of 61.64 years (range: 22-89) were included. There was no significant difference in onset age between male and female patients (61.75±11.10 vs 61.43±11.92, P=0.723).Tumour location (P=0.004), perineural invasion (PNI) (P=0.000), lymphovascular invasion (LVI) (P=0.000), tumour deposit (TD) (P=0.000), and differentiation grade (P=0.000) were significantly related to pathologic T stage in univariate analysis, while sex was not (p=0.192).Compared to patients with T1 disease, there was a significantly higher proportion of positive LVI in patients with stage T3 disease (P=0.011, OR=3.404, 95% CI: 1.319-8.787) but not in those with T2 (P=0.686, OR=0.804, 95% CI: 0.280-2.310) and T4 (P=0.063, OR=3.200, 95% CI: 0.941-10.886) disease. Compared to patients with T2 disease, there was a significantly higher proportion of perineural invasion in patients with stage T3 (P=0.000, OR=6.2376, 95% CI: 3.371-11.685) but not T4 (P=0.172, OR=2.309, 95% CI: 0.694-7.676) disease. Compared to patients with T1 disease, a significantly higher proportion of TDs occurred in patients with stage T3 (P=0.013, OR=6.106, 95% CI: 1.455-25.631) and stage T4 (P=0.019, OR=7.146, 95% CI: 1.378-37.044) but not stage T2 (P=0.435, OR=0.503, 95% CI: 0.089-2.824) disease. The overall incidence of lymph node metastasis was 44.9% (19.6% for T1, 23.6% for T2, 56.7% for T3, and 67.8% for T4). Patient age, sex, and tumour location did not significantly affect lymph node metastasis (LNM). The presence of LVI (OR=3.882, 95% CI=2.338-6.440, P=0.000), TD (OR=27.645, 95% CI=9.805-77.947, P=0.000), higher T stage (OR=1.969, 95% CI=1.471-2.635, P=0.000), and poorly differentiated histology (OR=2.255, 95% CI=1.544-3.293, P=0.000) were associated with a higher incidence of LNM on multivariate analysis. Perineural invasion (P=0.000) significantly affected LNM in univariate but not multivariate analysis (OR=1.213, 95% CI=0.734-2.003, P=0.452).Conclusion: There was no significant difference between male and female patients in onset age. Tumour location, PNI, LVI, TD, and differentiation grade were significantly related to pathologic T stage. Patients with the presence of LVI and TD, higher T stage, and poorly differentiated histology have a significantly higher chance of LNM.

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