PREOPERATIVE SPECT-CT VISUALIZATION OF SENTINEL LYMPH NODES IN PATIENTS WITH CERVICAL CANCER: PRELIMINARY ANALYSIS OF THE DATA

2019 ◽  
Vol 65 (4) ◽  
pp. 524-531
Author(s):  
Sergey Kanaev ◽  
M. Bisyarin ◽  
Pavel Krzhivitskiy ◽  
I. Berlev ◽  
Sergey Novikov ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Preliminary Analysis ◽  
Clinical Stage ◽  
Flow Patterns ◽  
Sentinel Lymph Nodes ◽  
Lymph Flow ◽  
Radiotherapy Planning ◽  
Iliac Region ◽  
Internal Iliac

Purpose: to determine preoperative SPECT-CT localization of sentinel lymph nodes (SLN) in women with cervical cancer. Materials and methods: SPECT-CT visualization of SLN was performed in 44 women with clinical stage IB-IIB cervical cancer. SPECT-CT examinations started 120-240 min after peritumoural injections of 99mTc-radiocolloids (200-300MBq in 0.4-1ml). All visualized LNs with uptake of radiocolloids were regarded as SLN. In all women we determined topography of SLN and lymph-flow patterns. Results: SLN were successfully visualized in 93.1% cases (41/44 women). The bilateral pattern of lymph flow was mentioned in 26 (63.4%), monolateral - in 15 (36.5%) cases. SLN localized in external iliac region in 25 (60.9%), internal iliac - in 14 (34.1%), obturator - in 22 (53.6%), presacral - in 1 (2.4%), common iliac region - in 21 (53,8%) cases. Uptake of radiocolloids in paraaortal lymph nodes was mentioned in 14 (34.1%) women Conclusion: SPECT-CT visualization of SLN can give important information for surgery and radiotherapy planning.

SPECT-CT VISUALIZATION OF SENTINEL LYMPH NODES AND LYMPH FLOW FROM TONGUE CANCER

2019 ◽  
Vol 65 (2) ◽  
pp. 250-255
Author(s):  
Sergey Kanaev ◽  
Sergey Novikov ◽  
Pavel Krzhivitskiy ◽  
Zamira Radzhabova ◽  
Maksim Kotov ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Parotid Gland ◽  
Lymph Nodes ◽  
Treatment Planning ◽  
Tongue Cancer ◽  
Primary Tumour ◽  
Sentinel Lymph Nodes ◽  
Lymph Flow ◽  
Radiotherapy Planning ◽  
Radiation Fields

The main purpose of the study was to determine distribution of sentinel lymph nodes in patients with tongue cancer. SPECT-CT visualization of sentinel lymph nodes was performed in 19 primary patients with clinically T1-2N0M0 tongue cancer. SPECT-CT acquisition started 60-120 min after peritumoral injections of 99mTc-nannocolloids (100-150MBq in 0.3-0.4ml). Finally we analyzed lymph flow patterns and localization of lymph nodes with radiocolloids uptake. Bilateral lymph flow from the tongue cancer was detected in 9 (47%) of 19 patients. In 6 cases bilateral pattern was associated with tumors less than 5mm from medial sulcus of the tongue. On the contrary, in 9 of 10 patients with lesions more than 4mm from medial sulcus we detected monolateral lymph-flow. In 4 (21%) of 19 patients SPECT-CT visualized sentinel lymph nodes only in groups Ib-IIa. Modeling of radiotherapy with with standard and lymph-flow guided radiation fields was performed on Eclips treatment planning station. It demonstrated that with lymph-flow guided strategy irradiated volumes can be reduced from 1224 cm3 to 367 cm3, dose to spinal cord can be reduced from 24,7Gy to 14.3Gy, medial dose to contralateral parotid gland - from 24,6Gy to 12,4 Gy. SPECT-CT with radiocolloids can be successfully used for visualization of lymph flow from the primary tumour and subsequent radiotherapy planning.

scholarly journals Lymph flow guided irradiation of regional lymph nodes in patients with cervical cancer: Preliminary analysis of scintigraphic data

2018 ◽  
Vol 23 (6) ◽  
pp. 503-509 ◽  
Author(s):  
Sergey Nikolaevich Novikov ◽  
Pavel Ivanovich Krzhivitskii ◽  
Sergey Vasilevich Kanaev ◽  
Igor Viktorovitch Berlev ◽  
Margarita Viktorovna Kargopolova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Preliminary Analysis ◽  
Lymph Flow ◽  
Regional Lymph Nodes

Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer

2003 ◽  
Vol 90 (2) ◽  
pp. 290-296 ◽  
Author(s):  
Marrije R Buist ◽  
Rik J Pijpers ◽  
Arthur van Lingen ◽  
Paul J van Diest ◽  
Jan Dijkstra ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Sentinel Lymph Nodes ◽  
Node Dissection ◽  
Early Stage Cervical Cancer

Status of sentinel lymph nodes in cervical cancer

2007 ◽  
Vol 107 (1) ◽  
pp. S18-S19 ◽  
Author(s):  
Charles F. Levenback
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Sentinel Lymph Nodes

scholarly journals Pathologic Protocols for Sentinel Lymph Nodes Ultrastaging in Cervical Cancer

2019 ◽  
Vol 144 (8) ◽  
pp. 1011-1020 ◽  
Author(s):  
Pavel Dundr ◽  
David Cibula ◽  
Kristýna Němejcová ◽  
Ivana Tichá ◽  
Michaela Bártů ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Adjuvant Radiotherapy ◽  
Pelvic Lymphadenectomy ◽  
Sentinel Lymph Nodes ◽  
Routine Clinical Practice ◽  
Data Sources ◽  
Crucial Aspect ◽  
Negative Prognostic Factor ◽  
Reporting Data

Context.— Ultrastaging of sentinel lymph nodes (SLNs) is a crucial aspect in the approach to SLN processing. No consensual protocol for pathologic ultrastaging has been approved by international societies to date. Objective.— To provide a review of the ultrastaging protocol and all its aspects related to the processing of SLNs in patients with cervical cancer. Data Sources.— In total, 127 publications reporting data from 9085 cases were identified in the literature. In 24% of studies, the information about SLN processing is entirely missing. No ultrastaging protocol was used in 7% of publications. When described, the differences in all aspects of SLN processing among the studies and institutions are substantial. This includes grossing of the SLN, which is not completely sliced and processed in almost 20% of studies. The reported protocols varied in all aspects of SLN processing, including the thickness of slices (range, 1–5 mm), the number of levels (range, 0–cut out until no tissue left), distance between the levels (range, 40–1000 μm), and number of sections per level (range, 1–5). Conclusions.— We found substantial differences in protocols used for SLN pathologic ultrastaging, which can impact sensitivity for detection of micrometastases and even small macrometastases. Since the involvement of pelvic lymph nodes is the most important negative prognostic factor, such profound discrepancies influence the referral of patients to adjuvant radiotherapy and could potentially cause treatment failure. It is urgent that international societies agree on a consensual protocol before SLN biopsy without pelvic lymphadenectomy is introduced into routine clinical practice.

Identification of risk factors associated with pelvic lymph node metastasis in patients with stage IB1 cervical cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18005-e18005
Author(s):  
Ping Jiang ◽  
Jing Cai ◽  
Xiaoqi He ◽  
Hongbo Wang ◽  
Weihong Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Node Metastasis ◽  
Parametrial Invasion ◽  
Pelvic Lymph Node Metastasis ◽  
Internal Iliac

e18005 Background: Evaluation the distribution of nodal metastases in the stage IB1 cervical cancer and the risk factors associated with pelvic lymph node metastasis (LNM) at each anatomic location. Methods: 728 patients with stage IB1 cervical cancer who underwent radical hysterectomies and systemic pelvic lymphadenectomies from January 2008 to December 2017 were retrospectively studied. All removed pelvic lymph nodes were pathologically examined, and the risk factors for LNM at the obturator, internal iliac, external iliac, and common iliac regions were evaluated by univariate and multivariate logistic regression analyses. Results: 20,134 lymph nodes were analysed with the average number of 27.80 (± SD 9.43) lymph nodes per patient. Nodal metastases were present in 266 (14.6%) patients. The obturator was the most common site for nodal metastasis (42.5%) followed by the internal iliac nodes (20.3%) and the external iliac nodes (19.9%), while the common iliac (9.8%) and parametrial (7.5%) nodes were the least likely to be involved. Tumor size more than 2 cm, histologically proven lymphovascular space involvement (LVSI) and parametrial invasion correlated independently significantly with the higher risk of the lymphatic metastasis. Obesity (BMI≥25) was independently significantly negatively correlated with the risk of lymphatic metastases. All the positive common iliac nodes were found in patients with tumors greater than 2 cm. The multivariate analysis showed that tumor size greater than 3 cm was associated with a 16.6-fold increase in the risk for common iliac LNM. Interestingly, tumor size was not an independent risk factor for pelvic LNM in the lower regions, i.e., the obturator, internal iliac and external iliac areas, where LVSI was the most significant predictor for LNM. In addition, parametrial invasion was related to external and internal iliac LNM; deep stromal invasion and age less than 50 years were associated with obturator LNM. Conclusions: The incidence of lymph node metastasis in patients with stage IB1 cervical cancer is low but prognostically relevant. The data offer the opportunity for tailored individual treatment in selected patients with small tumors and obesity.

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