Multicenter Validation Study of the Sentinel Lymph Node Concept in Cervical Cancer: AGO Study Group

Altgassen, C.; Hertel, Hermann; Brandstädt, A; Köhler, Christian; Dürst, Matthias; Schneider, Achim

doi:10.1200/jco.2007.13.8933

Cited by 263 publications

(182 citation statements)

References 38 publications

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“…Despite large studies have demonstrated a good diagnostic performance of SLN biopsy in cervical cancer patients, with a NPV ranging from 94.3% to 98.2%, one of the main concerns about its full adoption is the relatively low detection rate of the technique 11, 13, 20, 21, 22. As a matter of fact, looking at the official international literature, the frequency of a correct SLN identification really varies from one approach used to another and from a working team to another.…”

Section: Discussionmentioning

confidence: 99%

Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

et al. 2016

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Nowadays cervical cancer is frequently diagnosed at early stage. For these patients lymph node metastasis (LNM) is considered the most important prognostic factor. During the last decade many efforts have been made to reduce rate of complications associated with lymphadenectomy (LND). A great interest has arisen in sentinel lymph node (SLN) biopsy as a technique able to decrease number of LND performed and, at the same time, to assess lymph nodal status. High diagnostic performances have been reached thanks to SLN surgical algorithm. However, despite the efforts, about 25% of these patients undergo at least unilateral LND to meet NCCN recommendations. Data of women with International Federation of Gynecology and Obstetrics stage IA1‐IB1/IIA1 cervical carcinoma were retrospectively collected by six Italian institutions. All patients underwent complete preoperative staging workup and were primarily treated by radical hysterectomy and pelvic bilateral LND. A total of 368 patients with early‐stage cervical cancer were identified. Among them 333 (90.5%) showed no suspicious enlarged nodes at the preoperative magnetic resonance imaging (MRI). In this subset, tumor diameter ≥20 mm was the only independent predictor of LN status (P = 0.003). None of the 106 patients with negative MRI nodal assessment, with squamous and adenosquamous histotype and a tumor diameter less than 2 cm had LNM. Based on these results we propose a new modified SLN surgical algorithm that could safely reduce LND performed in patients with very low‐risk early‐stage cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

et al. 2016

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“…Am wichtigsten ist der Lymphknotenstatus, der laparoskopisch erhoben werden kann. Ist der Tumor im Durchmesser kleiner als 2 cm, ist das SentinelKonzept sinnvoll und mit einer Sensitivität von 90% und einem negativen Vorhersagewert von 99% auch zuverlässig [24].…”

Section: Gebärmutterhalsunclassified

Minutes of the Working Group on Gynecopathology and Breast Pathology

Lax¹,

Lebeau²,

Schneider³

2008

Pathologe

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“…Por lo tanto, la eliminación del tejido parametrial (parametrectomía) ha sido considerada como parte del manejo quirúrgico estándar de cáncer de cérvix. Sin embargo, este procedimiento puede producir denervación parcial de las vías autonómicas a los órganos de la pelvis asociada a disfunción de la vejiga, disfunción orgásmica y trastornos de la motilidad anorrectal (11)(12)(13) . Así, Landoni et al reportaron morbilidad tardía que incluye complicaciones urológicas y vesicales en más del 28% de 238 mujeres sometidas a HR (14) .…”

Section: Introductionunclassified

Compromiso parametrial en pacientes con cáncer de Cérvix IB-1 tratadas con histerectomía radical en Perú

Urrutia

Santos

Zevallos

et al. 2014

Rev Peru Med Exp Salud Publica

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Objetivos. Evaluar la frecuencia y factores asociados al compromiso parametrial (CP) en pacientes con cáncer de cérvix IB-1 sometidas a histerectomía radical (HR) en el Instituto Nacional de Enfermedades Neoplásicas del Perú. Materiales y métodos. Estudio transversal analítico en 214 pacientes con cáncer de cérvix IB-1 sometidas a HR con linfadenectomía pélvica entre el 2007 y 2012. Se comparó la población con y sin CP según variables clinicopatológicas como edad, tamaño tumoral, profundidad de infiltración, grado histológico y afectación ganglionar pélvica. Resultados. Diez pacientes (4,6%) presentaron CP. El análisis multivariable mostró que la profundidad de la invasión (OR 8,37, IC 95%: 1,41, p=0,029) y el compromiso de ganglios pélvicos (OR 18,03, IC 95%: 3,44, p=0,001) resultaron ser predictores independientes del CP. La presencia de tamaño tumoral ≤ 2 cm, invasión ≤ 10 mm, ausencia de permeación linfovascular y ausencia de compromiso ganglionar permitió identificar 97 pacientes de bajo riesgo de CP, de los cuales ninguno tuvo CP en patología. Conclusiones. Confirmamos la baja frecuencia del CP en el subgrupo de cáncer de cervix IB-1 y su asociación con la profundidad de la invasión y con el compromiso ganglionar linfático sugeridos en estudios previos. Esta información permitirá identificar un subgrupo de pacientes con bajo riesgo de CP candidatas a una cirugía menos radical en nuestra institución. Palabras clave: Cáncer del cuello uterino; Histerectomía; Escisión del ganglio linfático (fuente: DeCS BIREME). PARAMETRIAL INVOLVEMENT IN CERVICAL CANCER IB1 PATIENTS TREATED WITH RADICAL HYSTERECTOMY IN PERU ABSTRACTObjectives. To assess the frequency and factors associated with parametrial involvement (PI) in patients with cervical cancer IB1 who underwent radical hysterectomy (RH) at the National Institute of Neoplastic Diseases in Peru. Materials and methods. Cross-sectional study of 214 patients with cervical cancer IB1 undergoing RH with pelvic lymphadenectomy between 2007 and 2012. The population was compared with and without clinicopathological variables associated with PI such as age, tumor size, depth of infiltration, histological grade and pelvic lymph node involvement. Results. Ten patients (4.6%) had PI. Multivariate analysis showed that the depth of invasion (OR 8.37, p=0.029) and pelvic node involvement (OR 18.03; p=0.001) were all independent predictors of PI. The presence of tumor size ≤ 2 cm, invasion ≤ 10 mm, absence of lymphovascular permeation and absence of nodal involvement identified 97 patients at low risk of PI, none of whom had PI pathology. Conclusions. We confirmed the low frequency of PI in the cervical cancer IB1 subgroup and its association with the depth of invasion and lymph node involvement suggested in previous studies. This information will allow the identification of a subgroup of patients at low risk of PI for less radical surgery in our institution.

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Multicenter Validation Study of the Sentinel Lymph Node Concept in Cervical Cancer: AGO Study Group

Abstract: In our cohort (all stages), sensitivity of the sentinel concept was low. However, patients with tumor diameter

Cited by 263 publications

References 38 publications

Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

Minutes of the Working Group on Gynecopathology and Breast Pathology

Compromiso parametrial en pacientes con cáncer de Cérvix IB-1 tratadas con histerectomía radical en Perú

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