scholarly journals Possibilities and limits of modern metods of diagnosis of distant metastases locallyadvanced cervical cancer

2013 ◽  
Vol 62 (2) ◽  
pp. 172-178
Author(s):  
Margarita Vitaliyevna Kargopolova ◽  
Sergey Yanovich Maksimov ◽  
Igor Viktorovich Berlev ◽  
Anzhella Slavikovna Khadzhimba ◽  
Oleg Fedorovich Chepik ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Combined Treatment ◽  
Laparoscopic Approach ◽  
Distant Metastases ◽  
Recurrent Cervical Cancer ◽  
Paraaortic Lymphadenectomy ◽  
Short Period ◽  
Paraaortic Lymph Nodes ◽  
A Prospective Study

A retrospective study of 245 cases of recurrent cervical cancer, in every third case was detected metastases in paraaortic lymph nodes. Given these results, a prospective study aimed at optimizing the staging of cervical cancer Ib1–IIIb stages. Analyzed 48 clinical cases of patients with locally - common forms of cervical cancer, which before the combined treatment paraaortic lymphadenectomy was performed through laparoscopy with subsequent histological examination of surgical specimens. At the preoperative stage, to identify distant metastasis in para-aortic lymph nodes, patients were examined by various methods of radiation diagnosis. The sensitivity of MRI was 75 %, specificity 79 %, sensitivity and specificity of ultrasonography – 75 % and 93 %, respectively. The positive predictive value of the test was 25 % MRI, ultrasound – 50 %. Performing paraaortic lymphadenectomy with the greatest possible to individualize treatment policy and, as a consequence, to improve the results of combined treatment of patients with locally-common forms of cervical cancer. The use of laparoscopic approach, given the short period of rehabilitation, has not led to the postponement of chemoradiotherapy.

An Easy Irradiation Technique (Partial Half-Beam) to Reduce Renal Dose in Radiotherapy of Cervical Cancer Including Paraaortic Lymph Nodes

2008 ◽  
Vol 184 (9) ◽  
pp. 473-477 ◽  
Author(s):  
Hilke Vorwerk ◽  
Daniela Wagner ◽  
Hans Christiansen ◽  
Clemens Friedrich Hess ◽  
Robert Michael Hermann
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Paraaortic Lymph Nodes

Do the pelvic lymph nodes predict the parametrial status in cervical cancer stages IB–IIA?

2004 ◽  
Vol 14 (5) ◽  
pp. 832-840
Author(s):  
R. Puente ◽  
S. Guzman ◽  
E. Israel ◽  
M. T. Poblete
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Radical Surgery ◽  
Pelvic Lymphadenectomy ◽  
Pelvic Lymph Nodes ◽  
The Status ◽  
Parametrial Involvement ◽  
Significant Independent Factor ◽  
A Prospective Study

The aim of this study was to determine whether the pelvic lymph nodes would predict the parametrial status in patients with cervical cancer stages IB1–IIA submitted to radical surgery and pelvic lymphadenectomy. To this end, we evaluated the relationship between positive and negative pelvic lymph nodes and their parametria. Our final purpose was to use this information to recommend the tailoring of the parametrial resection according to the status of pelvic lymph nodes to decrease the morbidity related with radical paratrectomy. From January 1996 to December 2001, 107 consecutive patients with cervical cancer stages IB1 and IIA were primarily treated by radical hysterectomy type III with systematic pelvic lymphadenectomy in a prospective study. Parametria were studied in two sections: the first included the tissue adjacent to the cervix, and the second the distal 2/3. Lymph nodes were routinary processed. Twenty-two patients (20.6%) had positive pelvic nodes and 16 patients (14.9%) had parametrial involvement, mostly by direct extension. Eight patients with positive pelvic nodes (36.4%) had parametrial involvement, whereas among 85 patients with negative pelvic nodes only eight patients (9.4%) had parametrial involvement (P < 0.001), most in internal parametria (62.5%). The sensitivity of pelvic lymph nodes for parametrial involvement was 50% and the positive predictive value was 36.4%, whereas the specificity was 84.6%; and the negative predictive value 90.6%. In the group of negative pelvic lymph nodes, only two patients (2.3%) had parametrial involvement beyond internal parametria. The univariated and multivariated analysis of prognostic factors was always significant but without a significant independent factor for positive parametria. Pelvic lymph nodes appear as good predictors of parametrial status, especially in node-negative patients, and could be used to decrease the paratrectomy in radical surgery.

Evaluation of preoperative positron emission tomography with computed tomography (PET-CT) for detecting lymph node metastasis in gynecologic carcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5593-5593
Author(s):  
F. Murakami ◽  
N. Ogawa ◽  
A. Yamazaki ◽  
S. Sakurai ◽  
T. Ishiya ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Median Number ◽  
Maximum Diameter ◽  
Node Metastasis ◽  
Positron Emission ◽  
Paraaortic Lymphadenectomy ◽  
Pet Ct ◽  
Paraaortic Lymph Nodes

5593 Background: To evaluate the sensitivety, specificity, and accuracy of PET-CT for detecting lymph node metastasis in gynecologic carcinoma. Methods: Between May 2007 to August 2008, 36 consecutive patients (pts) with cervical carcinoma, endometrial carcinoma and epithelial ovarian carcinoma were enrolled. All pts underwent PET-CT prior to the surgery of systematic pelvic and paraaortic lymphadenectomy. For pathological metastatic lymph nodes, the size of intranodal tumor deposits (maximum diameter of metastatic foci in each lymph node) were recorded. Results: The total number of pelvic lymph nodes (PLNs) plus paraaortic lymph nodes (PANs) removed was 2426. The median number of removed lymph nodes (LNs) was 67 each pts (range: 25 to 102). The number of involvement LNs was 79 (3.5%). The sensitivity, specificity and accuracy of preoperative PET-CT to detect LN metastasis were 24%, 99.9%, and 97.5%, respectively. The sensitivity of PLNs and PANs were 39.5% and 7.3%, respectively. The sensitivity of squamous cell carcinoma (SCC) were 35.7%, that of adenocarcinoma were 8.1%. FDG-PET detected 100% of intranodal tumor deposits > or =10 mm, whereas tumor deposits smaller than 5 mm were not detected. Conclusions: The results of our study revealed 76% underdiagnosis (overlooking) in evaluation of preoperative PET-CT in LN metastasis. Particularly, tumor deposits smaller than 5 mm were not detected at all. Using PET-CT for detecting small LN metastasis in gynecologic carcinoma may be unreliable so far. However we found that PLNs are comparatively easy to be detected than PANs, and SCC are comparatively easy to be detected than adenocarcinoma. The improved usability and application of PET-CT for detecting LN metastasis in gynecologic carcinoma have to keep researching constructively. No significant financial relationships to disclose.

scholarly journals Sustained Complete Response after Maintenance Therapy with Topotecan and Erlotinib for Recurrent Cervical Cancer with Distant Metastases

2014 ◽  
Vol 7 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Donato Callegaro-Filho ◽  
John J. Kavanagh ◽  
Alpa M. Nick ◽  
Pedro T. Ramirez ◽  
Kathleen M. Schmeler
Keyword(s):  
Cervical Cancer ◽  
Maintenance Therapy ◽  
Distant Metastases ◽  
Complete Response ◽  
Recurrent Cervical Cancer

scholarly journals Lymphadenectomy for oncogynecological pathology: evaluation of lymph cyst formation and detection of metastases depending on the number of lymph nodes removed

2021 ◽  
Vol 20 (4) ◽  
pp. 31-37
Author(s):  
V. V. Saevets ◽  
Yu. A. Semenov ◽  
A. A. Muhin ◽  
A. V. Taratonov ◽  
M. N. Ivahno ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Radical Hysterectomy ◽  
Disease Recurrence ◽  
Surgical Staging ◽  
Cancer Group ◽  
Metastatic Lesions ◽  
Paraaortic Lymphadenectomy ◽  
Risk Of Disease ◽  
Lymphatic Cysts

Introduction. Lymphadenectomy in gynecological oncology allows performing adequate surgical staging, determining the need for adjuvant therapy, and reducing the risk of disease recurrence. An increase in the volume of lymphadenectomy leads to an increase in the incidence of postoperative complications — the formation of lymphatic cysts. There are no clear recommendations on the required number of removed lymph nodes in order to identify their metastatic lesions. The aim of the study was to study the possible dependence of the number of removed lymph nodes and the formation of lymphatic cysts. Materials and methods. A retrospective study of 219 patients after surgical treatment from 2020 to 2021 was carried out on the basis of GBUZ Chelyabinsk Regional Center of Oncology and Nuclear Medicine. The study included cases of stage I-IV uterine cancer of all histological types, which underwent radical hysterectomy with bilateral pelvic or bilateral pelvic and paraaortic lymphadenectomy; cases of cervical cancer stage IA1-IIA disease after radical hysterectomy II-III type according to the classification of M.S. Piver, F. Rutledge (1974) with performing bilateral pelvic lymphadectomy. Statistical processing of the results was carried out. Results. The percentage of complications (lymphatic cysts) in the cervical cancer group was 2.06% (N = 2), in the uterine body cancer group 1.72 (N = 2). There was no statistically significant relationship between the removed lymph nodes and their metastatic lesions. Removing more than 27 lymph nodes is a risk factor for developing lymphatic cysts. Discussion. Lymphadenectomy allows for adequate surgical staging and reduces the risk of disease recurrence. Complicated lymphatic cysts occur in 0.9-34% of cases, which was reflected in our study, but the percentage of these complications is quite low. Conclusion. The increase in the volume of lymphadenectomy (removal of more lymph nodes) is justified by the desire for accuracy in the surgical staging of the tumor process. Despite this, there is a risk of complications after lymphadenectomy — the formation of lymphatic cysts that occurs when 27 or more lymph nodes are removed.

scholarly journals Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

2015 ◽  
Vol 68 (7-8) ◽  
pp. 227-233
Author(s):  
Srdjan Djurdjevic ◽  
Sanja Stojanovic ◽  
Milos Pantelic ◽  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Radical Hysterectomy ◽  
Invasive Cervical Cancer ◽  
International Federation ◽  
Stage I ◽  
Stage Ii ◽  
Gynecology And Obstetrics ◽  
Paraaortic Lymph Nodes ◽  
Novi Sad

Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients? age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number of removed lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

scholarly journals Treatment and outcomes of early and operable recurrent cervical cancer: A prospective study

2021 ◽  
Vol 27 (1) ◽  
pp. 28
Author(s):  
Nikhil Mehta ◽  
SanjayM Desai ◽  
Vinod Dhakad ◽  
Dhruv Patel ◽  
Elroy Saldanha
Keyword(s):  
Cervical Cancer ◽  
Prospective Study ◽  
Recurrent Cervical Cancer ◽  
A Prospective Study
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