Identification Of Risk Factors In Patients With Positive Lymph Node After Radical Hysterectomy For Early Stage Cervical Cancer

Lymph node metastasis (LNM) is an important prognostic factor in cervical cancer (CC). In early stages, the risk of LNM is approximately 3.7 to 21.7%, and the 5-year overall survival decreases from 80% to 53% when metastatic disease is identified in the lymph nodes. Few reports have analyzed the relationship between miRNA expression and the presence of LNM. The aim of this study was to identify a subset of miRNAs related to LNM in early-stage CC patients. Formalin-fixed paraffin-embedded tissue blocks were collected from patients with early-stage CC treated by radical hysterectomy with lymphadenectomy. We analyzed samples from two groups of patients—one group with LNM and the other without LNM. Global miRNA expression was identified by microarray analysis, and cluster analysis was used to determine a subset of miRNAs associated with LNM. Microarray expression profiling identified a subset of 36 differentially expressed miRNAs in the two groups (fold change (FC) ≥ 1.5 and p < 0.01). We validated the expression of seven miRNAs; miR-487b, miR-29b-2-5p, and miR-195 were underexpressed, and miR-92b-5p, miR-483-5p, miR-4534, and miR-548ac were overexpressed according to the microarray experiments. This signature exhibited prognostic value for identifying early-stage CC patients with LNM. These findings may help detect LNM that cannot be observed in imaging studies.

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ASO Visual Abstract: Carcinomatosis in Early-Stage Cervical Cancer Treated with Robotic Radical Hysterectomy—Recurrence Patterns, Risk Factors, and Survival

Annals of Surgical Oncology ◽

10.1245/s10434-021-11148-x ◽

2021 ◽

Author(s):

Christine K. Fitzsimmons ◽

Amanda J. Stephens ◽

Jessica A. Kennard ◽

Madhavi Manyam ◽

Julie W. Pepe ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Radical Hysterectomy ◽

Early Stage ◽

Robotic Radical Hysterectomy ◽

Early Stage Cervical Cancer ◽

Recurrence Patterns

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Risk Factors for Recurrence after Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer: A Multicenter Retrospective Study

Cancers ◽

10.3390/cancers12113387 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3387

Author(s):

Jordi Ponce ◽

Sergi Fernandez-Gonzalez ◽

Antonio Gil-Moreno ◽

Pluvio J. Coronado ◽

Jesús De la Rosa ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Radical Hysterectomy ◽

Tumor Size ◽

Early Stage ◽

Tumor Grade ◽

Robot Assisted ◽

Invasive Approach ◽

Early Stage Cervical Cancer ◽

Risk Factors For Recurrence

This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women. After a median follow-up of 51 months, recurrence occurred in 26 patients (10.9%). Independent factors for recurrence were clinical tumor size > 20 mm (hazard ratio (HR) 2.37), adenocarcinoma as histological type (HR 2.51), positive pelvic lymph nodes (HR 4.83), tumor grade 2 (HR 4.99), tumor grade 3 (HR 8.06), and having not performed sentinel lymph node biopsy (SLNB) (HR 4.08). All 5 QI selected were surpassed by our results. In patients with early-stage cervical cancer undergoing robotic radical hysterectomy, clinicians should be aware that tumor grade 2 and 3, tumor size > 20 mm, adenocarcinoma, positive pelvic nodes, and lack of performance of SLNB are risk factors for recurrence. Fulfillment of QI targets of the ESGO might be considered as an objective oncological outcome indicator supporting the minimally invasive approach for early-stage cervical cancer treatment.

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EP241 Role of no further treatment after radical hysterectomy in early stage cervical cancer with intermediate risk factors

10.1136/ijgc-2019-esgo.302 ◽

2019 ◽

Author(s):

H Akilli ◽

L Aksoy Karakaş ◽

H Nihan ◽

K Esra ◽

A Ayhan

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Radical Hysterectomy ◽

Early Stage ◽

Intermediate Risk ◽

Early Stage Cervical Cancer

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Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000716 ◽

2017 ◽

Vol 27 (6) ◽

pp. 1222-1227 ◽

Cited By ~ 6

Author(s):

Tao Zhu ◽

Xi Chen ◽

Jianqing Zhu ◽

Yaqing Chen ◽

Aijun Yu ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Radical Hysterectomy ◽

Early Stage ◽

Pelvic Lymphadenectomy ◽

Tumor Diameter ◽

Laparoscopic Radical Hysterectomy ◽

Lymph Node Sampling ◽

Aortic Lymph Node ◽

Early Stage Cervical Cancer

Background and ObjectivesThe aim of this study was to compare the feasibility, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (LRH) with those of abdominal radical hysterectomy (ARH) for bulky early-stage cervical cancer.MethodsWe performed a retrospective cohort study of 112 patients with stage IB1 or IIA2 cervical cancer in which the tumor diameter was 3 cm or greater. All patients underwent LRH (n = 30) or ARH (n = 82) with pelvic lymphadenectomy and/or para-aortic lymph node sampling between May 2011 and November 2014. Perioperative outcomes were compared between the 2 surgical groups.ResultsThe laparoscopic approach consisted of 4 trocar insertions. Age, tumor diameter, and pelvic lymph nodes significantly differed between the 2 cohorts. Body mass index, International Federation of Gynecology and Obstetrics stage, histologic type and grade, deep stromal invasion, lymphovascular space invasion, positive margins, and adjuvant therapy were not significantly different between the 2 cohorts. Laparoscopic radical hysterectomy exhibited favorable results compared with ARH in terms of operating time, blood loss, intestinal exhaust time, and length of hospital stay. In addition, recurrence was observed in 5 LRH patients (16.7%) and 9 ARH patients (11.7%).ConclusionsThe surgical outcomes of LRH with pelvic lymphadenectomy and/or para-aortic lymph node sampling exhibited a similar therapeutic efficacy to those of the ARH approach.

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