Preoperatively Assessable Clinical and Pathological Risk Factors for Parametrial Involvement in Surgically Treated FIGO Stage IB–IIA Cervical Cancer

Canaz, Emel; Özyürek, Eser Şefik; Erdem, Baki; Talmaç, Merve Aldıkaçtıoğlu; Özaydın, İpek Yıldız; Akbayır, Özgür; Numanoğlu, Ceyhun; Ülker, Volkan

doi:10.1097/igc.0000000000001060

Cited by 28 publications

(32 citation statements)

References 42 publications

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“…Although parametrial invasion [10] and positive vaginal margin involvement [5,8,10] were more frequently associated with tumors ≥ 2 cm in diameter, some studies indicated no significant differences according to tumor size. Studies evaluating microinvasion observed during radical resection of the parametrium, which is the primary aim of radical surgery, showed that tumor size was an independent predictor of parametrial spread according to regression analyses [1,3,14]. In our study, parametrial invasion was only detected in eight patients.…”

Section: Discussionsupporting

confidence: 39%

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

et al. 2018

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Section: Discussionsupporting

confidence: 39%

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

et al. 2018

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“…We applied these extracted factors only to stage IB1, IB2, IIA1 and IIA2 cases and excluded IIB, as clinical T2b cervical cancer requires an adaptation of complete Type III RH or CCRT. When all three factors exceeded the identified thresholds (age > 50 years and tumor size >40 mm) or were positive (common lymph node In a previous report, Canaz et al 7 identified two predictive factors for PMI: endophytic presentation and a tumor size larger than 3 cm. However, in that study, PMI occurred in 29.1% of subjects with stage IB-IIA disease, a higher rate than that in our study or other reports.…”

Section: Discussionmentioning

confidence: 98%

“…In a previous report, Canaz et al identified two predictive factors for PMI: endophytic presentation and a tumor size larger than 3 cm. However, in that study, PMI occurred in 29.1% of subjects with stage IB–IIA disease, a higher rate than that in our study or other reports.…”

Section: Discussionmentioning

confidence: 99%

Search for conditions to avoid parametrectomy during radical hysterectomy for cervical cancer

Ito¹,

Sugiura²,

Toyoda³

et al. 2019

J of Obstet and Gynaecol

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Aim This study aimed to assess adequate conditions for omitting parametrectomy for stage IB1–IIA2 cervical cancer with the aim of reducing postoperative complications during Type III radical hysterectomy (RH). Methods We investigated factors associated with parametrial invasion (PMI) in patients who underwent Type III RH for stage IB1, IB2, IIA1, IIA2 and IIB cervical cancer at two tertiary institutions from November 2006 to February 2018. Both clinicopathological and preoperatively estimated factors were assessed. Results One hundred fifty‐six patients were preoperatively diagnosed with stage IB1 to IIB disease. Thirty‐four patients (21.8%) showed PMI on histological analyses. In the multivariate analysis, an age older than 50 years, tumor size larger than 40 mm, common iliac lymph node metastasis and lymphovascular space invasion were identified as significant risk factors for PMI ( P ‐values = 0.008, 0.003, 0.004 and 0.004, respectively). The preoperatively estimated risk factors for PMI were an older age, larger tumor size, and common iliac lymph node metastasis ( P ‐values = 0.007, 0.002 and 0.001, respectively). A combination of these three factors was sufficient to estimate PMI with a high specificity (100%) and positive predictive value (100%) in patients with stage IB1 to IIA2 disease. Conclusion During RH, resecting the posterior layer of the vesicouterine ligament and the paracolpium without removing the cardinal ligament (avoiding parametrectomy) might be feasible for stage IB1–IIA2 cervical cancer in patients younger than 50 years presenting with smaller tumors (<40 mm) and no common iliac lymph node metastasis.

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“…Complex clinical scenarios such as the shallowness or disappearance of the vaginal fornix in post-menopausal women, the bulky tumor extending to the vaginal wall, or the inflammation surrounding the tumor make it difficult to determine the degree of vaginal invasion. Canaz et al stated that vaginal invasion can be overestimated by clinical staging in comparison with the pathologic examination 23. Qin et al reported the accuracy of stage IIA as only 35.3% and that more than 50% of the patients with stage IIA were clinically overstaged 21.…”

Section: Discussionmentioning

confidence: 99%

Staging early cervical cancer in China: data from a multicenter collaborative

Zhang

Chen

Liu

et al. 2019

Int J Gynecol Cancer

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BackgroundIn 2018 the International Federation of Gynecology and Obstetrics (FIGO) revised the staging system of cervical cancer. This study aimed to assess the quality of staging early cervical cancer in China before the revision.MethodsThis multicenter retrospective study included 34 tertiary hospitals in China. Medical records of patients with cervical cancer who underwent primary surgical treatment between January 2010 and December 2015 were reviewed retrospectively. All patients were clinically staged according to the 2009 FIGO staging system. Eligibility criteria included: histopathologically confirmed cervical cancer; 2009 FIGO stage IA–IIA2 based on 2009 FIGO staging system; primary surgical treatment including extrafascial, type II or type III radical hysterectomy; radical trachelectomy; with or without pelvic lymphadenectomy; regardless of surgical route via laparotomy or laparoscopy; and complete clinical and pathological data. Patients who received non-surgical treatment, neoadjuvant treatment, or those with incomplete data were excluded. The accuracy of clinical staging was assessed by comparison between clinical and pathologic stage using the latter as the reference standard.ResultsA total of 23 933 cases of cervical cancer were identified and 12 681 fulfilled the inclusion criteria. Of these patients, 69.6% were staged accurately, 9.4% were clinically understaged, and 21.0% were clinically overstaged. The accuracy of stage IA, IB1, IB2, IIA1, and IIA2 was 90.0%, 87.5%, 57.4%, 20.3%, and 25.5%, respectively. The causes of stage inaccuracy were as follows: vaginal involvement (62.3%), maximal tumor diameter (24.6%), extent of cervical stromal invasion (7.1%), parametrial invasion (5.8%), bladder or rectal infiltration (0.1%), and distant metastases (0.1%).ConclusionThe accuracy of staging early cervical cancer in China was suboptimal before the revision of the staging system, especially for IIA1 and IIA2. The most common reasons for staging inaccuracy were vaginal involvement and tumor diameter.

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Preoperatively Assessable Clinical and Pathological Risk Factors for Parametrial Involvement in Surgically Treated FIGO Stage IB–IIA Cervical Cancer

Cited by 28 publications

References 42 publications

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

Search for conditions to avoid parametrectomy during radical hysterectomy for cervical cancer

Staging early cervical cancer in China: data from a multicenter collaborative

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