Lymph Node Involvement in Early-Stage Cervical Cancer: Is Lymphangiogenesis a Risk Factor? Results from the MICROCOL Study

Tantari, Matteo; Bogliolo, Stefano; Morotti, Matteo; Balaya, Vincent; Bouttitie, F.; Buénerd, Annie; Lécuru, Fabrice; Guani, Benedetta; Mathevet, Patrice

doi:10.3390/cancers14010212

Cited by 12 publications

(10 citation statements)

References 39 publications

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“…In this study, based on 2009 staging, there was a negative effect of LVSI on 5‐year OS in the after‐PSM subgroup of tumors ≤4 cm in diameter. Previous research has indicated that tumor LVSI is a significant risk factor for the metastasis of pelvic lymph nodes in cervical cancer 31 . Also, lymph node metastasis was a risk factor for 5‐year DFS in all three groups in the FIGO2009 staging.…”

Section: Discussionmentioning

confidence: 68%

“…Previous research has indicated that tumor LVSI is a significant risk factor for the metastasis of pelvic lymph nodes in cervical cancer. 31 Also, lymph node metastasis was a risk factor for 5-year DFS in all three groups in the FIGO2009 staging. Therefore, this group of patients should be treated with active adjuvant therapy postoperatively to improve their survival rate.…”

Section: Discussionmentioning

confidence: 81%

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Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Teng

Kang

et al. 2023

J of Obstet and Gynaecol

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Objective We aimed to compare the 5‐year oncological outcomes of laparoscopic/abdominal radical hysterectomy (LRH/ARH) in patients with cervical adenosquamous carcinoma at stage IA2 to IIA2 based on the 2009 or 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria. Methods Based on the clinical diagnosis and treatment of cervical cancer in China (Four C) database, Cox risk regression models were applied to analyze tumor prognosis treated with ARH/LRH in FIGO 2009 and 2018 IA2‐IIA2 patients and stratified findings according to tumor diameter (≤4 and >4 cm subgroups). And to avoid bias, propensity score matching (PSM) was also used for the cohort study. Results Based on FIGO 2009 staging criteria (n = 474), there was no significant difference between the ARH and LRH groups in 5‐year disease‐free survival (DFS) or overall survival (OS). Lymph node metastasis was a risk factor for 5‐year DFS in this stage. After PSM, lymphovascular space invasion (LVSI) was an independent risk factor for 5‐year OS in the tumors ≤4 cm subgroup. Based on FIGO2018 staging criteria (n = 322), cervical interstitial infiltration depth was an independent risk factor for 5‐year OS in the total population and the tumor diameter ≤4 cm subgroup. Conclusions Laparoscopic surgery was not a risk factor affecting the oncologic prognosis of adenosquamous carcinoma of the cervix based on either FIGO 2009 or 2018 staging of stage IA2‐IIA2. In addition, LRH may be considered for patients with early‐stage cervical adenosquamous carcinoma.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 81%

Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Teng

Kang

et al. 2023

J of Obstet and Gynaecol

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“…A surgical approach limiting a complete PALN dissection by using a combined primary pelvic and secondary para-aortic sentinel lymph node mapping technique, as reported here in our study, could reduce the potential risks and morbidity associated with this procedure, especially in the presence of increased surgical risk factors such as in obese and frail elderly patients ( 35 ). Similar to the primary pelvic sentinel lymph nodes, histologic ultrastaging using immunohistochemistry for identifying micrometastasis could be applied to the secondary para-aortic sentinel lymph nodes ( 36 ). A PALN dissection is especially indicated for patients with LACC and/or those with suspicious pelvic LNs but apparent normal para-aortic LNs on imaging.…”

Section: Discussionmentioning

confidence: 99%

Robotic Staging of Cervical Cancer With Simultaneous Detection of Primary Pelvic and Secondary Para-Aortic Sentinel Lymph Nodes: Reproducibility in a First Case Series

et al. 2022

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ObjectiveDiscrepancies exist among international guidelines on the surgical staging of para-aortic lymph nodes in locally advanced cervical cancer (LACC), varying from considering a para-aortic lymph node dissection, at least up to the inferior mesenteric artery, to a complete para-aortic lymph node dissection. In this study, we aim to assess the reproducibility of our recently reported robotic technique using indocyanine green for identifying besides primary pelvic sentinel lymph nodes (SLNs), secondary para-aortic SLNs in a first case-cohort of cervical cancer patients.MethodsA retrospective case series of LACC patients with/without suspicious pelvic lymph nodes (LNs) on imaging (including two patients with an additional suspicious para-aortic LN) is reported. All patients underwent a robotic pelvic SLN and para-aortic sentinel/nonsentinel LN dissection using the da Vinci Xi platform. Indocyanine green was used as a fluorescent tracer, at a concentration of 1.9 mg/mL, and injected as 0.5 mL in each quadrant of the cervix.ResultsIn a total of 10 cases, primary pelvic SLNs (90% bilateral) with subsequent secondary para-aortic SLNs were identified in all cases. Lower para-aortic SLNs were present in all cases, and upper para-aortic SLNs were found in 9 out of 10 cases. The mean age of the cervical cancer patients was 49.8 years (SD ± 6.89), and the mean body mass index (BMI; kg/m2) was 23.96 (SD ± 4.60). The median total operative time was 105.5 min (range: 89–141 min). The mean numbers of primary pelvic SLNs and secondary lower and upper para-aortic SLNs were 3.10 (SD ± 1.10), 2.90 (SD ± 0.74), and 2.30 (SD ± 1.57), respectively. The median number of total para-aortic LNs (PALNs) dissected per patient was 11.5. Six patients had positive primary pelvic SLNs, and two had secondary positive para-aortic SLNs. The nonsentinel para-aortic LNs were negative in all cases. There were no intra- or postoperative complications.ConclusionOur preliminary experience demonstrates the reproducibility of identifying, besides primary pelvic SLNs, secondary lower and upper para-aortic SLNs during robotic staging in LACC. A surgical approach limiting a complete para-aortic LN dissection could reduce the potential risks and morbidity associated with this procedure. To determine the sensitivity and negative predictive value of this new surgical approach, and whether the lower para-aortic SLNs under the inferior mesenteric artery are representative of the whole para-aortic region, large prospective observational studies are needed in LACC and/or those with suspicious pelvic LNs but apparent normal para-aortic LNs on imaging.

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“…Lymph node metastases (LNM) are routes of CC dissemination. LNM is a poor prognostic feature, even in patients with early-stage disease ( 70 ). The evaluation of preoperative LNM is based on medical imaging, which has limitations.…”

Section: Proteins As Predictive Biomarkers In CCmentioning

confidence: 99%

Promising predictive molecular biomarkers for cervical cancer (Review)

Lizano,

Carrillo‑García,

De La Cruz‑Hernández

et al. 2024

Int J Mol Med

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Cervical cancer (CC) constitutes a serious public health problem. Vaccination and screening programs have notably reduced the incidence of CC worldwide by >80%; however, the mortality rate in low-income countries remains high. The staging of CC is a determining factor in therapeutic strategies: The clinical management of early stages of CC includes surgery and/or radiotherapy, whereas radiotherapy and/or concurrent chemotherapy are the recommended therapeutic strategies for locally advanced CC. The histopathological characteristics of tumors can effectively serve as prognostic markers of radiotherapy response; however, the efficacy rate of radiotherapy may significantly differ among cancer patients. Failure of radiotherapy is commonly associated with a higher risk of recurrence, persistence and metastasis; therefore, radioresistance remains the most important and unresolved clinical problem. This condition highlights the importance of precision medicine in searching for possible predictive biomarkers to timely identify patients at risk of treatment response failure and provide tailored therapeutic strategies according to genetic and epigenetic characteristics. The present review aimed to summarize the evidence that supports the role of several proteins, methylation markers and non-coding RNAs as potential predictive biomarkers for CC.

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Lymph Node Involvement in Early-Stage Cervical Cancer: Is Lymphangiogenesis a Risk Factor? Results from the MICROCOL Study

Cited by 12 publications

References 39 publications

Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Robotic Staging of Cervical Cancer With Simultaneous Detection of Primary Pelvic and Secondary Para-Aortic Sentinel Lymph Nodes: Reproducibility in a First Case Series

Promising predictive molecular biomarkers for cervical cancer (Review)

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