Accuracy of lymph node palpation to determine need for lymphadenectomy in gynecologic malignancies

Arango, Hector; Hoffman, Mitchel S.; Roberts, William S.; DeCesare, Steven; Fiorica, James V.; Drake, James C.

doi:10.1016/s0029-7844(99)00607-9

Cited by 48 publications

(23 citation statements)

References 14 publications

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“…These authors suggested that systematic lymphadenectomy should be performed, rather than lymph node sampling, to determine the therapeutic impact of lymph node resection in epithelial ovarian cancers. Determining nodal metastases by palpation at the time of surgery has been found to have significant limitations (Petru et al, 1994;Arango et al, 2000;Eisenkop and Spirtos, 2001;Tangjitgamol et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

et al. 2007

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The aim of the study is to determine the role of lymphadenectomy in advanced epithelial ovarian cancer. The data were obtained from the Surveillance, Epidemiology and End Results (SEER) program reported between 1988 and 2001. Kaplan -Meier estimates and Cox proportional hazards regression models were used for analysis. Of 13 918 women with stage III -IV epithelial ovarian cancer (median age: 64 years), 87.9% were Caucasian, 5.6% African Americans, and 4.4% Asians. A total of 4260 (30.6%) underwent lymph node dissections with a median number of six nodes reported. For all patients, a more extensive lymph node dissection (0, 1, 2 -5, 6 -10, 11 -20, and 420 nodes) was associated with an improved 5-year disease-specific survival of 26.1, 35.2, 42.6, 48.4, 47.5, and 47.8%, respectively (Po0.001). Of the stage IIIC patients with nodal metastases, the extent of nodal resection (1, 2 -5, 6 -10, 11 -20, and 420 nodes) was associated with improved survivals of 36.9, 45.0, 47.8, 48.7, and 51.1%, respectively (P ¼ 0.023). On multivariate analysis, the extent of lymph node dissection and number of positive nodes were significant independent prognosticators after adjusting for age, year at diagnosis, stage, and grade of disease. The extent of lymphadenectomy is associated with an improved disease-specific survival of women with advanced epithelial ovarian cancer.

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Section: Discussionmentioning

confidence: 99%

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

et al. 2007

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“…It was reported a false-negative rate of 36% for intraoperative palpation in 126 women with gynecologic cancers undergoing LND, with a palpation sensitivity and specificity of 72 and 81%, respectively (Arango et al, 2000). Even with experienced hands, 36% of pelvic lymph nodes could not be determined using palpation.…”

Section: 6353 Risk Factors For Lymph Node Metastases With Endometriamentioning

confidence: 99%

Risk Factors of Lymph Node Metastases with Endometrial Carcinoma

Çetinkaya¹,

Atalay²,

Bacinoglu³

2014

Asian Pacific Journal of Cancer Prevention

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Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

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“…They were therefore placed in a separate schema from carcinomas in the AJCC 7th edition. 11,27 Carcinosarcoma (formerly known as malignant mixed M€ ullerian tumors) continue to be staged as carcinomas. Adenosarcoma of the uterus is a rare mixed neoplasm that includes both a benign epithelial component and a malignant stromal element.…”

Section: Analytic Cohortsmentioning

confidence: 99%

Site‐specific factors for cancer of the corpus uteri from SEER registries: Collaborative stage data collection system, version 1 and version 2

Jamison

Altekruse

Chang

et al. 2014

Cancer

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BACKGROUND: Uterine cancer is the fourth leading cancer among US women. Changes in uterine cancer staging were made from the American Joint Committee on Cancer (AJCC) 6th to 7th edition staging manuals, and 8 site-specific factors (SSFs) and 3 histologic schemas were introduced. Carcinomas account for 95% of cases and are the focus of this report. METHODS: Distributions of SSF values were examined for 11,601 cases of malignant cancer of the corpus uteri and uterus, NOS (not otherwise specified) diagnosed in Surveillance, Epidemiology, and End Results (SEER) Program registries during 2010. AJCC 6th and 7th edition staging distributions were compared for 11,176 cases using data in both staging systems. AJCC 6th edition staging distributions during 2004-2010 were examined. AJCC 7th edition SSFs required by SEER were International Federation of Gynecology and Obstetrics stage (SSF1), peritoneal cytology (SSF2), number of positive pelvic lymph nodes (SSF3), number of pelvic lymph nodes examined (SSF4), number of positive para-aortic lymph nodes (SSF5), and number of para-aortic lymph nodes examined (SSF6). RESULTS: For SSFs related to lymph nodes, a third of cases were classified as "not applicable," reflecting that lymph node dissection is not indicated for cases with stage1A and stage 4 diagnoses. AJCC 7th edition criteria assigned more cases to stage I (72.9%) than AJCC 6th edition criteria (68.7%). Annual counts significantly increased during 2004-2010, as did counts for AJCC 6th edition stages INOS, IA, IB, IC, IIIA, IIIB, IIIC, and IVB. The proportion of cases diagnosed with stage I cancer was stable, whereas stages II and IV decreased and stage III increased. CONCLUSIONS: Five SSFs were suitable for analysis: peritoneal cytology results (SSF2), numbers of positive pelvic lymph nodes (SSF3), pelvic lymph nodes examined (SSF4), positive para-aortic lymph nodes (SSF5), and para-aortic lymph nodes examined (SSF6). INTRODUCTIONAmong cancers of the female genital system, corpus uteri and corpus, not otherwise specified (NOS) is the most commonly diagnosed cancer and the second most common cause of cancer death after ovarian cancer. Overall, uterine cancer is the fourth most frequently diagnosed cancer among women in the United States, with 49,560 newly diagnosed cases and 8190 deaths estimated to occur during 2013. 1 Incidence rates historically have been slightly higher among white women than black women and women of other races; however, the mortality rate among black women is almost twice that of other women. 2 Factors affecting racial variation include tumor aggressiveness and racial differences in the prevalence of hysterectomy. 3,4 In recent years, the incidence rate of corpus uteri and corpus, NOS cancer has been increasing among women of all major racial and ethnic groups. Estrogen unopposed by progesterone is a main risk factor for endometrial cancer; and the increasing prevalence of obesity is thought to contribute to the recent increase in incidence. 5 Diabetes and nulliparity are both risk factors that ...

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Accuracy of lymph node palpation to determine need for lymphadenectomy in gynecologic malignancies

Abstract: Obstetrics & Gynecology 95 (2000) 553-556. doi:10.1016/S0029-7844(99)00607-9Received by publisher: 1999-06-25Harvest Date: 2016-01-04 12:20:32DOI: 10.1016/S0029-7844(99)00607-9Page Range: 553-55

Cited by 48 publications

References 14 publications

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

Risk Factors of Lymph Node Metastases with Endometrial Carcinoma

Site‐specific factors for cancer of the corpus uteri from SEER registries: Collaborative stage data collection system, version 1 and version 2

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