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.

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.

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

An observational longitudinal study to evaluate miction, defecation, and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer

2006 ◽  
Vol 16 (3) ◽  
pp. 1119-1129 ◽  
Author(s):  
Q. D. Pieterse ◽  
C. P. Maas ◽  
M. M. Ter Kuile ◽  
M. Lowik ◽  
M. A. Van Eijkeren ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Longitudinal Study ◽  
Sexual Function ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Control Group ◽  
Negative Effects ◽  
Early Stage Cervical Cancer

The objective of this study was to evaluate the problems with miction, defecation, and sexuality after a radical hysterectomy with or without adjuvant radiotherapy for the treatment of cervical cancer stage I–IIA. This study included an observational longitudinal study of self-reported bladder, defecation, and sexual problems with a baseline score. Ninety-four women were included in the study. An age-matched control group consisted of 224 women. The patients showed significantly more negative effects on sexual function compared with both the controls and their situation before the treatment throughout 24 months of follow-up. The problems included less lubrication, a narrow and short vagina, senseless areas around the labia, dyspareunia, and sexual dissatisfaction. Up to 12 months after the treatment, the patients complained significantly more of little or no urge to urinate and diarrhea as compared with the controls. Adjuvant radiotherapy did not increase the risk of bladder dysfunction, colorectal motility disorders, and sexual functions. We conclude that a radical hysterectomy for the treatment of early-stage cervical carcinoma is associated with adverse effects mainly on sexual functioning.

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

Delayed adjuvant radiotherapy in early-stage cervical cancer with intermediate-risk features has a detrimental effect on survival that cannot be corrected by adjuvant chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6037-6037
Author(s):  
Joyson Kodiyan ◽  
Adel Guirguis ◽  
Hani Ashmalla
Keyword(s):  
Cervical Cancer ◽  
Adjuvant Chemotherapy ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Positive Margin ◽  
Pelvic Lymphadenectomy ◽  
Intermediate Risk ◽  
Early Stage Disease ◽  
Early Stage Cervical Cancer

6037 Background: GOG-0263 is currently investigating the role of adjuvant chemotherapy (CT) concurrently with radiotherapy (RT) in patients with early stage cervical cancer that underwent radical hysterectomy and pelvic lymphadenectomy harboring intermediate risk features. We used a retrospective database to investigate whether adjuvant chemotherapy significantly influenced overall survival (OS), and whether its effectiveness is influenced by delays in radiotherapy. Methods: All data was obtained from the NCDB (National Cancer Database) and initially contained 115,747 cases of cervical cancer diagnosed between 2004 and 2015. Analyzed patients had early stage disease, received radical hysterectomy with pathologic stage I to IIA, and had intermediate risk features including size greater than 4 cm or lymphovascular invasion. All patients received adjuvant RT with or without CT. Cases with positive margin or nodes, with parametrial extension, or metastasis were excluded. Cases were weighted by inverse probability of treatment (CT) using clinical and socioeconomic variables, and analyzed for OS using multivariate models. Predictors of receiving CT were determined using multivariate logistic regression. Results: The final cohort was 557 patients with median follow-up of 43 months (range, 1.54-143.7). Median survival without CT (n = 244) versus with CT (n = 313) was 42.2 versus 43.9 months (HR 0.81, 95%CI 0.661-0.995, p = 0.045). Median time from diagnosis to RT was 91 days (range, 21-691), and predicted for inferior OS (p = 0.007). No significant interaction existed between RT delay and receipt of CT (p = 0.997). Cases with squamous histology were less likely to receive CT than adenocarcinoma histology (OR 0.345, 95%CI 0.159-0.725, p = 0.006). Conclusions: Poor survival outcomes are observed in patients with early stage cervical cancer harboring intermediate risk features when adjuvant radiotherapy is delayed. This outcome was not corrected by addition of chemotherapy.

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