Identification of Micrometastases in Histologically Negative Lymph Nodes of Early-Stage Cervical Cancer Patients

Lentz, Scott E.; Muderspach, Laila I.; Felix, Janine F.; Wei, Ye; Groshen, Susan; Amezcua, Charles A.

doi:10.1097/01.aog.0000125869.78251.5e

Cited by 86 publications

(53 citation statements)

References 16 publications

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“…Moreover, Van Trappen et al (4) also noted that 44% of pathologically-negative lymph nodes expressed CK19, and that early micrometastases occured in 50% of patients with cervical cancer. In this study the detection rate of micrometastases by IHC for detecting CK19 expresssion in pathological lymph nodes of cervical cancer was 24.6%, while Lentz et al (11), using similar method, index and materials, found micrometastases occurred in 15% of the patients and that the detection rate of micrometastases in lymph nodes was 0.9%, both of the percentages are lower than ours. The incidence rates of micrometastases in our study detected by ISH and IHC (60 and 46.6%, respectively) were also higher than that reported in other literature.…”

Section: Discussioncontrasting

confidence: 71%

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

et al. 2012

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Abstract. The aim of this study was to investigate the detection rate and methods of micrometastases in early-stage cervical cancer by detecting the expression of high-risk HPV DNA and CK19 in pelvic lymph nodes. A total of 104 lymph nodes with/without pathologically confirmed metastases, from 28 patients with early-stage cervical cancer, were included for detection of high-risk HPV DNA and CK19 expression using in situ hybridization and immunohistochemistry, respectively. The detection rate of high-risk HPV DNA and CK19 in lymph nodes in patients with pathologically-confirmed lymph node metastases was higher compared to that in lymph nodes in patients without pathologically-confirmed lymph node metastases (P<0.001). In all 80 pathologically-negative lymph nodes, the positivity rates of high-risk HPV DNA and CK19 detection were 45 and 25%, respectively. In 57 lymph nodes in patients without pathologically-confirmed lymph node metastases the positivity rates of high-risk HPV DNA and CK19 detection were 43.5 and 24.6%. The detection rate of high-risk HPV DNA and CDK19 in 15 patients without pathologically-confirmed lymph node metastases were 60 and 46.6%, respectively. The detection rates of high-risk HPV DNA and CK19 in 104 lymph nodes were 56.7 and 41.3% (KI=0.46). The results of the two detection methods showed good consistency. Both detection of high-risk HPV DNA by in situ hybridization, and CK19 by immunohistochemical method detected lymph node micrometastases in early-stage cervical cancer. As a method of detection on the molecular level, in situ hybridization was more sensitive for the detection of lymph node micrometastases in early-stage cervical cancer.

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Section: Discussioncontrasting

confidence: 71%

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

et al. 2012

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“…Recently, sentinel lymph node biopsy has become common, and when these lymph nodes are negative for metastasis, many gynecologists omit the systematic lymphadenectomy. There are many benefits of this method, including low invasiveness and a low rate of complications [14,15], but Marchiole et al [16] reported that the sentinel lymph node biopsy method resulted in 14.3% false negatives, and Lentz et al [17] described that 15% of the negative sentinel nodes had micrometastasis. Therefore, a complete lymphadenectomy may be able to elevate the detection rate of LNM and may improve the prognosis in cases with 1 or 2 LNM sites.…”

Section: Discussionmentioning

confidence: 99%

Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy

et al. 2010

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“…Furthermore, LND significantly impacts postoperative treatment decisions in clinically early stage disease due to upstaging solely resulting from lymph node involvement. 2,7,14,[21][22][23][24][25][26] Therefore, the surgeon should make an effort to retrieve as many lymph nodes as possible even in obese patients. Unfortunately, obese women were less likely to undergo a surgical assessment of their lymph nodes than non-obese women in the past.…”

Section: -11mentioning

confidence: 99%

Obesity does not affect the number of retrieved lymph nodes and the rate of intraoperative complications in gynecologic cancers

et al. 2010

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Objective: Lymphadenectomy, in general, is a safe and well-tolerated procedure in gynecologic oncology. However, some technical difficulties may be experienced in obese women which may result in inadequate lymphadenectomy and increased complications. The purpose of this study is to retrospectively evaluate the effect of obesity on lymph node counts retrieved and complication rates observed during lymphadenectomy in gynecologic cancers. Methods: Patients with ovarian, endometrial or cervical cancers treated with initial surgery including bilateral pelvic and paraaortic lymph node dissection were grouped as non-obese and obese. These two groups were compared in terms of the number of retrieved lymph nodes and the rate of intraoperative complications directly related to lymph node dissection. Results: One hundred twenty-three patients were eligible with a mean age of 55.1 years and mean body mass index of 29.2 kg/m 2 . Fifty-nine patients were obese while 64 were non-obese. Lymph node counts obtained in different stations and in total were similar among non-obese and obese patients. Rates of lymphadenectomy-related intraoperative complications including vascular, neural, intestinal, and bladder injury were also similar in non-obese and obese patients. Conclusion:The obesity does not affect the lymph node counts and intraoperative complication rates adversely in women with gynecologic cancers. Therefore, adequate lymph node dissection should not be omitted based solely upon obesity in gynecologic oncology patients.

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Identification of Micrometastases in Histologically Negative Lymph Nodes of Early-Stage Cervical Cancer Patients

Abstract: II-3

Cited by 86 publications

References 16 publications

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy

Obesity does not affect the number of retrieved lymph nodes and the rate of intraoperative complications in gynecologic cancers

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