Clinical impact of low-volume lymph node metastases in early-stage cervical cancer: A comprehensive meta-analysis

Guani, Benedetta; Mahiou, Katia; Crestani, Adrien; Cibula, David; Buda, Alessandro; Gaillard, Thomas; Mathevet, Patrice; Kocián, Roman; Śniadecki, Marcin; Wydra, Dariusz; Féki, Anis; Paolettí, Xavier; Lécuru, Fabrice; Balaya, Vincent

doi:10.1016/j.ygyno.2021.12.015

Cited by 31 publications

(22 citation statements)

References 46 publications

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“… 30 Ultrastaging of SLNs makes it possible to identify micrometastases and isolated tumor cells, although the impact of these findings remains to be demonstrated. 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

“…In a study of data from the SENTICOL study, 60.5% of detected SLNs were in the external iliac and interiliac basin, while a substantial proportion were in unusual locations, namely 19.6% in the common iliac, 11.8% in the para‐aortic, and 6% in the parametrium 30 . Ultrastaging of SLNs makes it possible to identify micrometastases and isolated tumor cells, although the impact of these findings remains to be demonstrated 31,32 …”

Section: Discussionmentioning

confidence: 99%

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Impact of therapeutic strategy on disease‐free and overall survival of early‐stage cervical cancer: Surgery alone versus preoperative radiation

et al. 2023

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Background and Objectives There is no international consensus for management of early‐stage cervical cancer (ESCC). This study aimed to retrospectively investigate disease‐free survival (DFS) and overall survival (OS) in patients with ESCC according to the therapeutic strategy used, surgery alone versus preoperative radiation following by surgery. Methods Data were retrospectively collected from 1998 to 2015 using the Gynecological Cancer Registry of the Côte d'Or. The inclusion criteria were FIGO 2018 ≤ IB2; squamous cell carcinoma, adenocarcinoma or adenosquamous type. Survival curves were compared using the log‐rank test. Results One hundred twenty‐six patients were included. Median survival was 90 months. There was no significant difference in DFS (HR = 0.91, 95%CI [0.32–2.53], p = 0.858) or in OS between surgery alone versus preoperative radiation following by surgery (HR = 0.97, 95%CI [0.31–2.99], p = 0.961). In the subgroup of patients with stage ≥IB1, there was no significant difference in DFS (HR = 3.26, p = 0.2) or in OS (HR = 3.87, p = 0.2). Conclusion Our study did not identify any difference in survival according to the treatment strategy. Preoperative radiation following by surgery can be an alternative to surgery alone for ESCC.

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“… 30 Ultrastaging of SLNs makes it possible to identify micrometastases and isolated tumor cells, although the impact of these findings remains to be demonstrated. 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of therapeutic strategy on disease‐free and overall survival of early‐stage cervical cancer: Surgery alone versus preoperative radiation

et al. 2023

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“…However, the clinical impact and treatment of low-volume lymph node metastases remain controversial. A meta-analysis by Guani et al (37) concluded that MIC had a negative effect on DFS and OS, while ITC was not significantly associated with DFS or OS. These results indicated that MIC should be considered true metastasis and treated accordingly.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting pelvic lymph node metastasis and prognosis in patients with cervical cancer

Wang

Yang

et al. 2022

Front. Oncol.

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ObjectiveCervical cancer (CC) is one of the main causes of death among gynecological malignancies. Patients with CC with lymph node metastasis (LNM) have poor prognoses. We investigated the risk factors and prognosis of LNM in patients with CC patients using data from the SEER database.MethodsWe collected the information of cervical cancer patients registered in SEER database from 2010 to 2015. The dataset was divided into a training set and a validation set at a 7:3 ratio. LASSO regression analysis was used to evaluate risk factors for LNM in patients with CC. Using the results, we established a nomogram prediction model. C-index, ROC curves, calibration curves, decision curve analysis, and clinical impact curves were used to evaluate the prediction performance of the model.ResultsWe included 14,356 patients with CC in the analysis. Among these, 3997 patients were diagnosed with LNM. A training set (10,050 cases) and a validation set (4306 cases) were used for the following analysis. We established nomogram LNM prediction models for the patients with T1-2-stage CC. The C-indices for the internal and external validations of the prediction models were 0.758 and 0.744, respectively. In addition, we established a prognostic nomogram for all CC patients with LNM, and the internal and external validation C-indices were 0.763 and 0.737.ConclusionWe constructed a quantitative and visual predictive nomogram that predicted prognosis of patients with LNM in CC to provide clinicians with a reference for diagnosis and treatment.

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“…47 The SENTIX trial (Table 2) demonstrated that all sentinel nodes were detected in the pelvic external iliac, interiliac, common iliac and presacral regions. 44 The SENTICOL III trial 49 is a prospective multicentre randomised study comparing disease-free survival and health-related quality of life in patients with negative SLNalone versus patients with negative SLN and pelvic lymphadenectomy. The trial aims to validate the use of SLN biopsy in early-stage cervical cancer, assuming noninferiority of SLN biopsy in terms of disease-free survival and superiority of SLN biopsy in health-related quality of life.…”

Section: Oncological Safetymentioning

confidence: 99%

“…11,44,48 A recent meta-analysis reported survival outcomes comparing women with micrometastases or ITCs and women with micrometastases-only to those with negative nodes. 49 In terms of disease-free survival, the hazard ratio (HR) was 2.6 (95% CI 1.6-4.3) and 4.1 (95% CI 2.7-6.2), respectively 49 and for overall survival, the HR was 5.7 (95% CI 2.8-11.4) and 6.9 (95% CI 2.6-18.8), respectively. 49 This suggests that low-volume metastatic nodal disease appears to have a negative impact on survival in cervical cancer.…”

Section: Oncological Safetymentioning

confidence: 99%

Sentinel lymph node mapping in the modern management of gynaecological malignancy

Collins

Phillips

2023

The Obstetric & Gynaecologis

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Sentinel lymph node (SLN) biopsy is an alternative to systematic lymphadenectomy in the surgical staging of gynaecological malignancy. It is recommended in the management of vulval cancer and is increasingly used in endometrial and cervical cancer. SLN failed mapping algorithms require that side-specific lymphadenectomy should be performed in the case of failed mapping, and that suspicious lymph nodes are removed. Ultrastaging protocols improve detection of lymph-node metastasis and should be used for the pathological processing of SLNs. Learning objectivesTo understand the rationale, use and evidence for SLN biopsy in women with vulval, cervical and endometrial malignancy.To appreciate the concepts behind the technical performance of SLN biopsy. To understand the pathological processing of SLN samples and the implications this may have for the interpretation of results and adjuvant therapy. Ethical issuesHow to manage adjuvant therapy decisions in the context of micrometastases or isolated tumour cells in positive pelvic SLNs in cervical or endometrial cancer when the evidence-base is limited.

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Clinical impact of low-volume lymph node metastases in early-stage cervical cancer: A comprehensive meta-analysis

Cited by 31 publications

References 46 publications

Impact of therapeutic strategy on disease‐free and overall survival of early‐stage cervical cancer: Surgery alone versus preoperative radiation

Impact of therapeutic strategy on disease‐free and overall survival of early‐stage cervical cancer: Surgery alone versus preoperative radiation

Development and validation of a nomogram for predicting pelvic lymph node metastasis and prognosis in patients with cervical cancer

Sentinel lymph node mapping in the modern management of gynaecological malignancy

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