Conization pathologic features as a predictor of intermediate and high risk features on radical hysterectomy specimens in early stage cervical cancer

Hutchcraft, Megan L.; Smith, B.; McLaughlin, Eric; Hade, Erinn M.; Backes, Floor J.; O’Malley, David M.; Cohn, David E.; Fowler, Jeffrey M.; Salani, Ritu

doi:10.1016/j.ygyno.2019.01.026

Cited by 12 publications

(16 citation statements)

References 14 publications

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“…Previous studies have investigated the predictive value of pathologic features of conization specimens [ 22 , 23 , 24 , 25 ] and highlighted that conization specimens should be considered in the preoperative staging of patients with early-stage cervical cancer. Smith et al showed that the presence of LVSI in conization specimens and positive pelvic lymph nodes were predictive for parametrial involvement and radicality of hysterectomy could be determined based on these features [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have investigated the predictive value of pathologic features of preoperative conization specimens for parametrial involvement [ 22 ], residual disease [ 23 , 24 ] and pathologic risk-factors [ 25 ] on radical hysterectomy specimens. Among the previously identified risk factors of lymph node metastasis, tumor size, LVSI and depth of stromal invasion might be assessed in conization specimens.…”

Section: Introductionmentioning

confidence: 99%

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Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Balaya

Guani

Mereaux

et al. 2021

Cancers

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Background: The prognosis of patients with cervical cancer is significantly worsened in case of lymph node involvement. The goal of this study was to determine whether pathologic features in conization specimens can predict the sentinel lymph node (SLN) status in early-stage cervical cancer. Methods: An ancillary analysis of two prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) was carried out. Patients with IA to IB2 2018 FIGO stage, who underwent preoperative conization before SLN biopsy were included. Results: Between January 2005 and July 2012, 161 patients from 25 French centers fulfilled the inclusion criteria. Macrometastases, micrometastases and Isolated tumor cells (ITCs) were found in 4 (2.5%), 6 (3.7%) and 5 (3.1%) patients respectively. Compared to negative SLN patients, patients with micrometastatic and macrometastatic SLN were more likely to have lymphovascular space invasion (LVSI) (60% vs. 29.5%, p = 0.04) and deep stromal invasion (DSI) ≥ 10 mm (50% vs. 17.8%, p = 0.04). Among the 93 patients with DSI < 10 mm and absence of LVSI on conization specimens, three patients (3.2%) had ITCs and only one (1.1%) had micrometastases. Conclusions: Patients with DSI < 10 mm and no LVSI in conization specimens had lower risk of micro- and macrometastatic SLN. In this subpopulation, full node dissection may be questionable in case of SLN unilateral detection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Balaya

Guani

Mereaux

et al. 2021

Cancers

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“…By contrast, this strategy allows performing ultrastaging and decreases false-negative cases. During the first step, a minimally invasive SLN mapping may be associated in the same time with a conisation which would enhances a more precise risk assessment before radical surgery [43,44].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging

Balaya

Guani

Benoit³

et al. 2020

Gynecologic Oncology

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Objectives. We aimed to assess the diagnostic value of frozen-section pathologic examination (FSE) of sentinel lymph nodes (SLN) in patients with early-stage cervical cancer. Methods. Two French prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) were analysed. Patients with IA to IIA1 2018 FIGO stage, who underwent SLN biopsy with both FSE and ultrastaging examination were included. Results and discussion. Between 2005 and 2012, 313 patients from 25 centers fulfilled the inclusion criteria. Metastatic involvement of SLN was diagnosed in 52 patients (16.6%). Macrometastases, micrometastases and isolated tumor cells (ITCs) were found in 27, 12 and 13 patients respectively. Among the 928 SLNs analysed, FSE identified 23 SLNs with macrometastases in 20 patients and 5 SLNs with micrometastases in 2 patients whereas no ITCs were identified. Ultrastaging of negative SLNs by FSE found macrometastases, micrometastases and ITCs in additional 7, 11 and 17 SLNs. Ultrastaging increased significantly the rate of patients with positive SLN from 7% to 16.6% (p b 0.0001). The sensitivity and the negative predictive value of FSE were 42.3% and 89.7% respectively or 56.4% and 94.1% if ITCs were excluded. False-negative cases were more frequent with tumor size ≥ 20 mm (OR = 4.46, 95%IC = [1.45-13.66], p = 0.01) and preoperative brachytherapy (OR = 4.47, 95%IC = [1.37-14.63], p = 0.01) and less frequent with patients included in higher volume center (N5 patients/year) (OR = 0.09, 95%IC = [0.02-0.51], p = 0.01).

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“…Outra alternativa para reduzir a probabilidade de tratamentos somados, e diagnosticar a presença de invasão angiolinfática, seria realizar sistematicamente além dos exames de imagem, conização, antes da histerectomia radical. As pacientes com critérios de Sedlis (invasão angiolinfática, invasão estromal profunda e tamanho maior que 4 cm ou 5 cm) presentes seriam encaminhadas para rádio e quimioterapia [16][17][18] . Essa estratégia, porém, acarretaria um procedimento cirúrgico adicional, com morbidade desconhecida e atraso no tratamento definitivo.…”

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“…Classicamente são divididos em dois grupos baseado no seu potencial oncogênico. Os tipos16,18,31,33,35,39,45,51,52,56,58,59, 66 e 68 estão envolvidos com maior chance para desenvolvimento do câncer e por isso são denominados de alto risco.Enquanto os tipos 6, 11, 42, 43 e 44 são denominados de baixo risco41 .Em um estudo conduzido no Instituto do Câncer do Estado de São Paulo (ICESP) com cerca de 300 pacientes, Nogueira Dias Genta et al42 , verificaram que os HPVs mais prevalentes em nossa população de pacientes com câncer de colo uterino são: 16 (64%) e 18 (10%). Os autores também verificaram que a infecção múltipla determinou pior prognóstico.…”

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Papel da expressão imunoistoquímica das moléculas de adesão catenina-beta, e-caderina, L1CAM, e da expressão de vimentina, no risco de comprometimento linfonodal no câncer do colo do útero

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Conization pathologic features as a predictor of intermediate and high risk features on radical hysterectomy specimens in early stage cervical cancer

Cited by 12 publications

References 14 publications

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging

Papel da expressão imunoistoquímica das moléculas de adesão catenina-beta, e-caderina, L1CAM, e da expressão de vimentina, no risco de comprometimento linfonodal no câncer do colo do útero

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