Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix: Extended diagnostic evaluation for paraaortic node metastasis—A Gynecologic Oncology Group study

Heller, Paul B.; Malfetano, John H.; Bundy, Brian N.; Barnhill, Danny; Okagaki, Takashi

doi:10.1016/0090-8258(90)90085-y

Cited by 186 publications

(69 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, a Gynecologic Oncology Group study involving 264 patients found the sensitivity of a CT scan for identifying para-aortic nodal metastasis to be only 34% for cervical carcinoma (8). In non-small cell lung cancers, Prenzel et al reported that the overall positive predictive value was 30.8%, using 80 preoperative CT scans in the diagnosis of the involvement of mediastinal lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

et al. 2005

View full text Add to dashboard Cite

ObjectivesThe extent of para-aortic lymph nodes (PANs) metastasis is equivalent to distant metastases in patients with biliary carcinoma. Accurate preoperative assessment of PANs metastasis has a crucial impact on surgical indication. In this retrospective study, we evaluated whether computed tomography (CT) scans were useful for diagnosing PANs metastases and excluding patients with PANs metastases from surgical indication. MethodsBetween March 1999 and November 2003, 57 patients with biliary carcinoma underwent radical lymphadenectomy or surgical biopsy of PANs, nine of whom was diagnosed as having positive PANs microscopically. All patients had undergone abdominal CT scans before surgery. To diagnose PANs metastases, we used the following diagnostic criteria. 1) Size: when lymph nodes were greater than 12 mm, 10 mm, 8 mm or 6mm in diameter in long or short axis diameter, the nodes were considered metastatic. 2) Shape and size: when the axial ratio of a lymph node was greater than 0.5, 0.7, 1.0, and the maximum diameter in the long or short axis was greater than 12 mm, 10 mm, 8 mm, or 6mm the node was considered metastatic. 3)Internal structure: if the internal structure of a PANs was heterogeneous, the node was 2 considered metastatic. The positive predictive value was calculated for each included criterion when patients numbered 10 or more. ResultsPositive predictive values using these criteria range from 13% to 36%. Only one patient had PANs with heterogeneous internal structures. ConclusionWe were unable to determine surgical indication based on the morphological criteria revealed by a CT scan.

show abstract

Section: Discussionmentioning

confidence: 99%

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

et al. 2005

View full text Add to dashboard Cite

show abstract

“…In women presenting with nodal involvement (N1), the 5-year overall survival is dramatically reduced by nearly 30-40% in comparison to that of patients classified as N0 [22,23,24]. In particular, para-aortic nodal status has been shown to be the most powerful parameter for patient outcomes [25,26]. On the other hand, the recent introduction of combined therapies including radiation therapy plus sensitising chemotherapy gives rise to rational hopes in terms of prolonged survival [27,28,29].…”

Section: N Stagingmentioning

confidence: 99%

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

Belhocine

2004

Gynecol Surg

View full text Add to dashboard Cite

Growing evidence indicates that whole-body 18 F-fluorodeoxyglucose positron emission tomography (wb-18 FDG PET) plus pelvic magnetic resonance imaging (pMRI) may significantly improve the pre-treatment staging of primary cervical cancers. Such a combined protocol provides complementary insights into primary tumour delineation, loco-regional involvement and distant spread. As such, pMRI appears particularly reliable for the accurate measurement of tumour size, the detection of parametrial invasion and, even more so, for its exclusion. So far, wb-18 FDG PET yields unique information about extra-pelvic nodal and visceral tumour status. Of note, however, is the limitation of both imaging techniques for the detection of microscopic pelvic lymph node metastases, especially in early stage disease. Promising data also highlight the prognostic value of 18 FDG uptake as a marker of disease aggressiveness and of tumour resistance to treatment. The recent development of combined PET-CT scans as well as the validation of the sentinel node concept in gynaecological malignancies may grant new perspectives for optimal management of cervical cancers in the pre-treatment setting.

show abstract

“…Only a minority of centers (14%) in our study use LAG for nodal status evaluation, most of them use CT or NMR, which are known to be less sensitive and speci®c than LAG. However, as shown by the Gynecologic Oncology Group (GOG), LAG has a sensitivity of 79% and speci®city of 73%, whereas CT and ultrasound have sensitivities of 34 and 19%, and speci®ci-ties of 96 and 99%, respectively [15]. The importance and utility of LAG, especially if external radiotherapy is planned, is con®rmed by the work of Bonin et al, who demonstrated that bony landmarks are not an adequate substitute for LAG for the localization of pelvic lymph nodes [3].…”

Section: Pretreatment Evaluation and Staging In Cervical Cancermentioning

confidence: 99%

“…Neoadjuvant chemotherapy is used by 11 centers, concomitant chemo±radiation therapy by 15 There is a general trend to introduce more and more chemotherapy with higher stage disease. Cisplatin is the most commonly used chemotherapeutic agent.…”

Section: Chemotherapymentioning

confidence: 99%

A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer

Coucke

Maingon

Ciernik

et al. 2000

Radiotherapy and Oncology

View full text Add to dashboard Cite

Background: The treatment outcome of advanced stage uterine cervical carcinoma remains unsatisfactory. In order to elaborate a novel trial within The Radiotherapy Cooperative Group (RCG) of the European Organization for Research and Treatment of Cancer (EORTC), we conducted a survey in 1997±1998 to determine the variability of pre-treatment assessment and treatment options. The variability of choosing surgery, de®ned radiation therapy techniques and chemotherapy are investigated, as well as the center's choices of future treatment strategies.Methods: Fifty two of 81 RCG centers from the RCG have participated in the survey. As one would expect, there is a large variation in the techniques used for pretreatment evaluation and treatment options. There is no`standard' for reporting acute and late side effects. Chemotherapy is used neither systematically nor uniformly, and some centers continue to use neadjuvant chemotherapy modalities.Results: Furthermore, the survey reveals that there is a strong demand for the reduction of overall treatment-time, for clinical investigation of novel combined modality treatment strategies, especially chemo±radiation therapy, and also for the use of new radiation sensitizers.Conclusion: We conclude that a more homogeneous approach to the pretreatment evaluation as well as treatment techniques is required in order to allow adequate quality control in any future trial of the RCG in the EORTC. q

show abstract

Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix: Extended diagnostic evaluation for paraaortic node metastasis—A Gynecologic Oncology Group study

Cited by 186 publications

References 15 publications

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer

Contact Info

Product

Resources

About