scholarly journals Noninvasive CT radiomic model for preoperative prediction of lymph node metastasis in early cervical carcinoma

2020 ◽  
Vol 93 (1108) ◽  
pp. 20190558
Author(s):  
Jiaming Chen ◽  
Bingxi He ◽  
Di Dong ◽  
Ping Liu ◽  
Hui Duan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Ct Images ◽  
International Federation ◽  
Clinical Feature ◽  
Data Set ◽  
Node Metastasis ◽  
Gynecology And Obstetrics ◽  
Model Combining

Objective: To build and validate a CT radiomic model for pre-operatively predicting lymph node metastasis in early cervical carcinoma. Methods and materials: A data set of 150 patients with Stage IB1 to IIA2 cervical carcinoma was retrospectively collected from the Nanfang hospital and separated into a training cohort (n = 104) and test cohort (n = 46). A total of 348 radiomic features were extracted from the delay phase of CT images. Mann–Whitney U test, recursive feature elimination, and backward elimination were used to select key radiomic features. Ridge logistics regression was used to build a radiomic model for prediction of lymph node metastasis (LNM) status by combining radiomic and clinical features. The area under the receiver operating characteristic curve (AUC) and κ test were applied to verify the model. Results: Two radiomic features from delay phase CT images and one clinical feature were associated with LNM status: log-sigma-2–0 mm-3D_glcm_Idn (p = 0.01937), wavelet-HL_firstorder_Median (p = 0.03592), and Stage IB (p = 0.03608). Radiomic model was built consisting of the three features, and the AUCs were 0.80 (95% confidence interval: 0.70 ~ 0.90) and 0.75 (95% confidence intervalI: 0.53 ~ 0.93) in training and test cohorts, respectively. The κ coefficient was 0.84, showing excellent consistency. Conclusion: A non-invasive radiomic model, combining two radiomic features and a International Federation of Gynecology and Obstetrics stage, was built for prediction of LNM status in early cervical carcinoma. This model could serve as a pre-operative tool. Advances in knowledge: A noninvasive CT radiomic model, combining two radiomic features and the International Federation of Gynecology and Obstetrics stage, was built for prediction of LNM status in early cervical carcinoma.

DNA Ploidy is Stronger Than Lymph Node Metastasis as Prognostic Factor in Cervical Carcinoma: 10-Year Results of a Prospective Study

2011 ◽  
Vol 21 (4) ◽  
pp. 678-684 ◽  
Author(s):  
Tommaso Susini ◽  
Simone Olivieri ◽  
Cecilia Molino ◽  
Gianni Amunni ◽  
Stefano Rapi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Dna Ploidy ◽  
International Federation ◽  
Disease Specific Survival ◽  
Node Metastasis ◽  
Disease Specific

Introduction:To improve the outcome of patients with cervical cancer, a more accurate prognostic assessment is essential. The aim of this study was to evaluate the role of tumor DNA ploidy as an independent prognostic factor in cervical carcinoma. Furthermore, we investigated whether the presence of lymph node metastasis may have a different clinical impact according to ploidy status.Methods:In a long-term prospective study, DNA ploidy was evaluated by flow cytometry from fresh tumor samples from 136 patients with cervical cancer who underwent surgery. Ploidy, lymph node metastasis, and other classical parameters were analyzed in relation to the length of disease-specific survival. Treatment modalities did not differ between patients with diploid tumors and patients with aneuploid tumors.Results:DNA aneuploidy was found in 52 patients (38.2%). Patients with DNA-aneuploid tumors had a significantly reduced disease-specific survival (P= 0.003). Overall, the 10-year survival probability was 54% for patients with DNA-aneuploid tumors and 80% for patients with DNA-diploid tumors. Among 64 patients with International Federation of Gynecologists and Obstetricians stage I disease, the 10-year survival rates were 38.7% for the patients with DNA-aneuploid tumors and 86.3% for those with DNA-diploid tumors (P= 0.003). Overall, diploid tumors with lymph node metastasis did significantly better than aneuploid tumors with lymph node metastasis (P= 0.05). Among the patients with International Federation of Gynecologists and Obstetricians stage I disease, there was a highly significant difference between patients with diploid node-positive tumors and patients with aneuploid node-positive tumors, with no deaths from the disease in the former group in contrast with the worst outcome in the latter group (P= 0.005). By multivariate analysis, pathologic tumor stage, lymph vascular invasion, and tumor ploidy were significant and independent parameters, whereas lymph node metastasis yielded no independent information.Conclusions:DNA ploidy was an independent prognostic factor in cervical carcinoma. Presence of lymph node metastasis may not always have the same impact on survival but may vary according to DNA ploidy of the primary tumor.

Significance of the Absolute Number and Ratio of Metastatic Lymph Nodes in Predicting Postoperative Survival for the International Federation of Gynecology and Obstetrics Stage IA2 to IIA Cervical Cancer

2013 ◽  
Vol 23 (1) ◽  
pp. 157-163 ◽  
Author(s):  
Ying Chen ◽  
Lei Zhang ◽  
Jing Tian ◽  
Xin Fu ◽  
Xiubao Ren ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
International Federation ◽  
Proportional Hazard ◽  
Metastatic Lymph Nodes ◽  
Node Metastasis ◽  
Cox Proportional Hazard ◽  
Gynecology And Obstetrics

PurposeThis study aimed to evaluate the ratio of metastatic and removed lymph nodes (RPL) and the number of metastatic lymph nodes (MLNs) in predicting postoperative survival for International Federation of Gynecology and Obstetrics stage IA2 to IIA cervical cancer after radical hysterectomy and pelvic lymphadenectomy (RHPL).MethodsA retrospective study was conducted in which 120 patients with lymph node metastasis who underwent RHPL for cervical cancer from 2000 to 2006 was analyzed to identify the prognostic indicators by using Kaplan-Meier and Cox proportional hazard methods.ResultsOf 588 patients with cervical cancer who underwent RHPL, the 5-year survival rate (YSR) of 120 with lymph node metastasis was much lower than that of 468 without lymph node metastasis (22.4% vs 84.4%, P < 0.001). By cut-point survival analysis, RPL cutoff was designed as 10%, with the 5-YSR of 42.9% and 11.8%, and MLN count cutoffs were designed as 1 and 5, with the 5-YSR of 62.5%, 20.8%, and 7.8%, respectively. With univariate analysis, increasing RPL and MLN counts were associated with a poorer survival in women with node metastasis cervical cancers. Stage, histologic grade, RPL, and MLN count were significant independent prognostic factors for survival in a multivariate Cox proportional hazard model. In addition, RPL was verified superior to MLN count in prognostic evaluation for patients with IA2 to IIA cervical cancer after RHPL because the hazard ratio of RPL (3.195) was higher than that of MLN count (1.578).ConclusionsThe RPL and MLN count may be used as the independent prognostic parameters in patients with cervical cancer with lymph node metastasis after RHPL. Comparison of the superiority of RPL and MLN count for better predicting the survival of patients with cervical cancer deserves to be investigated further.

Uterine corpus invasion as a risk factor in patients with early-stage cervical carcinoma receiving radical surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17012-e17012
Author(s):  
Yifan Li ◽  
Ning Li ◽  
Lingying Wu
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Radical Surgery ◽  
Early Stage ◽  
Univariate Analysis ◽  
Uterine Corpus ◽  
Node Metastasis

e17012 Background: To explore whether pathologically verified uterine corpus invasion (UCI) is a risk factor for patients with early-stage (IB1-IIA2) cervical carcinoma receiving radical surgery. Methods: A mathed-case comparison of early-stage cervical carcinoma patients with pathologically verified UCI to patients without UCI on a 1:1 ratio was conducted. High risk factors (lymph node metastasis, paremetrial invasion, vaginal margin invasion) and intermediate risk factors (lymphovascular space invasion (LVSI) and deep stromal invasion) were completely matched between UCI and non-UCI groups. Kaplan-Meier and Log-rank test were applied for univariate analysis, and COX proportional hazard regression models were used for multivariate analysis. Results: 1320 consecutive patients with cervical carcinoma received surgery in our centerfrom Jan. 1st2009 to Dec 31st2014. 79 (5.98%) cases with UCI were identified. Median follow-up time was 43 months. There were 22 cases with recurrence. In UCI group, the recurrence rate was 20.3% (16/79), and in non-UCI group the recurrence rate was 7.6% (6/79). On univariate analysis, SCC, neoadjuvant chemotherapy (NACT), lymph node metastasis, parametrial invasion, LVSI, deep stromal invasion, vaginal invasion and UCI were significantly associated with disease free survival (DFS). After multivariate analysis, UCI ( p= 0.02, RR3.832, 95% CI1.235-11.893)and lymph node metastasis ( p= 0.042, RR 2.890, 95% CI1.038-8.045) were still independent risk factors for deceased DFS. Conclusions: Pathologically verified uterine corpus invasion might be an independent risk factor for decreased DFS in patients with early-stage cervical carcinoma receiving radical surgery.

scholarly journals Theurapeutic Response of Neoadjuvant Chemotherapy between Platinum and Ifosfamide Combination and Platinum, Vincristine and Bleomycin Combination in Cervical Carcinoma Stage IB2

2016 ◽  
Author(s):  
Kartiwa H Nuryanto ◽  
Sigit Purbadi
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Acute Toxicity ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Complete Response ◽  
Pelvic Lymphadenectomy ◽  
Chemotherapy Response ◽  
Node Metastasis

Objective: To evaluate the theurapeutic response and acute toxicity of neoadjuvant chemotherapy between the combination of Platinum and Ifosfamide, and the combination of Platinum, Vincristine and Bleomycin in Cervical Carcinoma Stage IB2 and then continued with radical hysterectomy and pelvic lymphadenectomy. Method: Thirteen samples received neoadjuvant chemotherapy of Platinum and Ifosfamide and 17 samples received neoadjuvant chemotherapy of Platinum, Vincristine and Bleomycin, after receiving the neoadjuvant chemotherapy, clinically complete response samples underwent radical hysterectomy and pelvic lymphadenectomy (PI VS PVB = 3 VS 1). Histopathology examination was performed to evaluate the presence of malignant viable cells at the cervix, pelvic lymph node metastasis and parametrium metastasis. Acute toxicity evaluation was performed based on gastrointestinal, genitourinarius and hematology sign and symptom. Result: Theurapeutic response of PI is 1.12 higher than PVB (p>0.05). Subanalysis of group response of PI is 1.962 higher than PVB. PI and PVB have the same risk to have pelvic lymph node metastasis, but not parametrial metastasis. There were no differences in terms of the risk of gastrointestinal, genitourinarius and hematologic toxicity between PI and PVB. Conclusion: There was no statistical difference in clinical and pathological response, and also in acute toxicity between the two combination (p>0.05). [Indones J Obstet Gynecol 2016; 1: 47-51] Keywords: acute toxicity, cervical carcinoma stage IB2, neoadjuvant chemotherapy, response

scholarly journals Comprehensive analysis of lymph nodes metastasis associated genes in cervical cancer and its significance in treatment and prognosis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ping Yang ◽  
Youqin Ruan ◽  
Zhiling Yan ◽  
Yang Gao ◽  
Hongying Yang ◽  
...  
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Risk Score ◽  
Risk Groups ◽  
Node Metastasis ◽  
Prognostic Gene ◽  
Prognostic Gene Signature ◽  
Score Model

Abstract Background Cervical carcinoma is one of the most common malignant tumors of the female reproductive system. Lymph nodes metastasis, the most common metastasis, which can be detected even in small-size tumor patients, results in worse prognosis. Therefore, it is of great significance to explore novel lymph nodes metastasis associated biomarkers, which can predict the prognosis and provide a good reference for clinical decision making in cervical carcinoma patients. However, systematic and comprehensive studies related to the key molecules in lymph node metastasis in cervical carcinoma patients are still absent. Methods Transcriptome and clinical data of 307 cervical carcinoma patients were obtained from The Cancer Genome Atlas (TCGA). Then, survival of patients with and without lymph node metastasis was analyzed by Kaplan-Meier (K-M) curves. Differential expressed genes (DEGs) were detected between tumor and control samples using limma package and defined as lymph node metastasis related genes. Univariate and multivariate Cox regression analyses were carried out to screen robust prognostic gene signature. The risk score model and nomogram for predicting survival were constructed based on prognostic gene signature. The performance of the risk score model was evaluated by operating characteristic (ROC) curves. Based on risk score, patients were divided into low- and high- risk groups. DEGs, functional enrichment analysis and tumor microenvironment (immune infiltration and expressions of immune checkpoints) were detected in low- and high-risk groups. Results A total of 103 lymph node metastasis-associated genes were identified. Univariate and multivariate Cox regression analyses identified TEKT2, LPIN2, FABP4 and CXCL2 as prognostic gene signature. The risk score model was constructed and validated in cervical carcinoma patients. 345 DEGs identified between high- and low-risk groups were significantly enriched into immune-related biological processes. Furthermore, we found that the immune infiltration and expressions of immune checkpoints were significantly different between low- and high-risk groups. Conclusion Our study revealed that lymph node metastasis played an important role in the prognosis of cervical carcinoma patients. Furthermore, we established a risk score model based on lymph node metastasis related genes, which could accurately predict the survival of cervical carcinoma patients. Besides, our findings in tumor microenvironments of low- and high-risk groups improved our understanding of the relationship between lymph node metastasis related genes and cervical carcinoma.

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