A single-center retrospective analysis to evaluate the prognostic role of lymph node density in patients with lymph node-positive cervical cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17013-e17013
Author(s):  
Arkadius A. Polasik ◽  
Wolfgang Janni ◽  
Christoph Scholz ◽  
Nikolaus De Gregorio ◽  
Fabienne Schochter ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Retrospective Analysis ◽  
Prognostic Role ◽  
Node Density ◽  
Lymph Node Density ◽  
Lymph Node Positive ◽  
Positive Lymph Nodes

e17013 Background: The aim of this retrospective analysis is to evaluate the prognostic role of lymph node density (LND), i.e. the ratio of positive lymph nodes to the total number of lymph nodes removed during surgery, in nodal-positive cervical cancer patients. Methods: Out of 266 patients with cervical cancer that underwent surgery including lymphonodectomy between 2000 and 2017 at the Department for Gynecology and Obstetrics of the University Hospital Ulm, 86 patients with positive lymph nodes were included in the analysis. According to former study results, patients were divided into two groups with LND < 10% vs. ≥ 10%. Univariable and multivariable cox-regression models (adjusted for age, histological subtype, grading, body mass index, R-status, lymphangiosis, histologically confirmed FIGO-status and chemotherapy) were used to evaluate the association between LND and both overall survival (OS) and disease-free survival (DFS). Results: In the 86 patients, a median of 42 lymph nodes were removed (range 11 – 107), and a median of 2 lymph nodes (range 1 – 25) were found positive. 57 (66.3%) patients had a LND < 10% and 29 (33.7%) patients had a LND ≥ 10%. There was no significant association between LND (≥ 10% vs. < 10%) and OS in both univariable (hazard ratio[HR] 1.49, 95% CI 0.72 – 3.07, p = 0.280) and multivariable survival analysis (HR 1.46, 95% CI 0.64 – 3.32, p = 0.372), respectively. However, LND was significantly associated with DFS in univariable analysis (HR 2.11, 95% CI 1.10 – 4.03, p = 0.024) and was found to be an independent predictor for DFS in adjusted multivariable analysis (HR 2.30, 95% CI 1.08 – 4.91, p = 0.031). Conclusions: LND ≥ 10% in patients with lymph node-positive cervical cancer is associated with a worsened DFS compared to patients with a LND < 10%. Thus, LND may be used as an independent prognostic marker and/or for risk stratification in these patients.

1591 PROGNOSTIC ROLE OF LYMPH NODE DENSITY IN PN+ PATIENTS AT RADICAL CYSTECTOMY: A MULTICENTRE STUDY

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Giuseppe Simone ◽  
Rocco Papalia ◽  
Salvatore Guaglianone ◽  
Mariaconsiglia Ferriero ◽  
Emanuela Altobelli ◽  
...  
Keyword(s):  
Lymph Node ◽  
Multicentre Study ◽  
Radical Cystectomy ◽  
Prognostic Role ◽  
Node Density ◽  
Lymph Node Density

scholarly journals Reply: Lymph node density as a surrogate marker for positive lymph nodes

2010 ◽  
Vol 104 (1) ◽  
pp. 223-223
Author(s):  
S Polterauer ◽  
C Grimm ◽  
A Reinthaller ◽  
C Tempfer
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Surrogate Marker ◽  
Node Density ◽  
Lymph Node Density ◽  
Positive Lymph Nodes

scholarly journals Lymph node density as a surrogate marker for positive lymph nodes

2010 ◽  
Vol 104 (1) ◽  
pp. 221-222 ◽  
Author(s):  
T Van Gorp ◽  
A J Kruse ◽  
B F Slangen ◽  
R F Kruitwagen
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Surrogate Marker ◽  
Node Density ◽  
Lymph Node Density ◽  
Positive Lymph Nodes

Renal Lymph Nodes for Tumor Staging: Appraisal of 871 Nephrectomies With Examination of Hilar Fat

2013 ◽  
Vol 137 (11) ◽  
pp. 1584-1590 ◽  
Author(s):  
Vikas Mehta ◽  
Kumaran Mudaliar ◽  
Ritu Ghai ◽  
Marcus L. Quek ◽  
John Milner ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Microscopic Examination ◽  
Renal Cell ◽  
Fatty Tissue ◽  
Renal Malignancies ◽  
Positive Lymph Nodes

Context.—Despite decades of research, the role of lymphadenectomy in the management of renal cell carcinoma (RCC) is still not clearly defined. Before the implementation of targeted therapies, lymph node metastases were considered to be a portent of markedly decreased survival, regardless of the tumor stage. However, the role of lymphadenectomy and the relative benefit of retroperitoneal lymph node dissection in the context of modern adjunctive therapies have not been conclusively addressed in the clinical literature. The current pathologic literature does not offer clear recommendations with regard to the minimum number of lymph nodes that should be examined in order to accurately stage the pN in renal cell carcinoma. Although gross examination of the hilar fat to assess the nodal status is performed routinely, it has not yet been determined whether this approach is adequate. Objective.—To evaluate the status of lymph nodes and their rate of identification in the pathologic examination of nephrectomy specimens in adult renal malignancies. Design.—We reviewed the operative and pathology reports of 871 patients with renal malignancies treated by nephrectomy. All tumors were classified according to the seventh edition of the Tumor-Nodes-Metastasis classification. Patients were divided into 3 groups: Nx, no lymph nodes recovered; N0, negative; and N1, with positive lymph nodes. Grossly visible lymph nodes were submitted separately; as per grossing protocol, hilar fatty tissue was submitted for microscopic examination. We evaluated the factors that affected the number of lymph nodes identified and the variables that allowed the prediction of nodal involvement. Results.—Lymph nodes were recovered in 333 of 871 patients (38%): hilar in 125 patients, nonhilar in 137 patients, and hilar and nonhilar in 71 patients. Patients with positive lymph nodes (n = 87) were younger, had larger primary tumors, and had lymph nodes of average size, as well as a higher pT stage, nuclear grade, and rate of metastases. Metastases were seen only in grossly identified lymph nodes (65% hilar, 16% nonhilar); all microscopic nodes were negative. Even with the microscopic examination of fat, hilar lymph nodes were recovered in only 22.5% of patients. A nonhilar route of node metastasis was suspected in 40 patients. Conclusions.—Only grossly identifiable lymph nodes, both hilar and nonhilar, were positive for metastases. Although microscopic examination of the hilar fat increased the number of lymph nodes recovered, the identification rate of these nodes was low (22.5%), and such microscopic nodes were invariably negative. Hence, microscopic examination of the hilar fat may be unnecessary.

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