Assessment of retroperitoneal lymph node status in locally advanced cervical cancer.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read Online Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Lymph Nodes/*pathology ; Lymphatic Metastasis/*pathology ; Uterine Cervical Neoplasms/*pathology; Adult ; Aged ; Antigens, Neoplasm/blood ; Area Under Curve ; Carcinoma/blood ; Carcinoma/diagnostic imaging ; Carcinoma/pathology ; Carcinoma/therapy ; Carcinoma, Squamous Cell/blood ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/therapy ; Female ; Humans ; Laparoscopy ; Lymph Node Excision/methods ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/immunology ; Middle Aged ; Radiotherapy, Intensity-Modulated ; Retroperitoneal Space ; Risk Factors ; Sensitivity and Specificity ; Serpins/blood ; Tomography, Spiral Computed ; Uterine Cervical Neoplasms/blood ; Uterine Cervical Neoplasms/diagnostic imaging ; Uterine Cervical Neoplasms/therapy ; Young Adult
    • Abstract:
      Background: The assessment of retroperitoneal lymph node status in patients with locally advanced cervical cancer is still a problem. This study aimed to explore the choice of these assessment methods.
      Methods: Laparoscopic retroperitoneal lymphadenectomy was performed in 96 patients with advanced cervical cancer. The positive rates of lymph node metastasis were analyzed. The values of computed tomography lymph node minimum axial diameter (MAD) and squamous cell carcinoma antigen (SCC-Ag), and their combination in predicting retroperitoneal lymph node metastasis were compared. High-risk factors for common iliac lymph node (CILN) and/or para-aortic lymph node (PALN) metastasis were analyzed.
      Results: The lymph node metastasis rate was 62.50% and the CILN and/or PALN metastasis rate was 31.25%. Overall, 96 patients had 172 visible lymph nodes. The positive rate of lymph node metastasis was significantly higher in the MAD ≥1.0 cm group (83.33%) than in the 0.5 cm ≤ MAD < 1.0 cm group (26.82%). The critical values of MAD and SCC-Ag in determining lymph node metastasis were 1.0 cm and 5.2 ng/mL, respectively. The accuracy, specificity, and Youden index of MAD ≥1.0 cm combined with SCC-Ag ≥ 5.2 ng/mL for evaluating lymph node metastasis were 75.71%, 100%, and 0.59, respectively, and were significantly different from the values for the MAD ≥1.0 cm (72.09%, 80.56%, and 0.47, respectively) and SCC-Ag ≥ 5.2 ng/mL (71.43%, 68.97%, and 0.42, respectively) groups. Correlation analysis showed that non-squamous cell carcinoma, pelvic lymph node (PLN) MAD ≥1.0 cm plus number ≥ 2, and 1 PLN MAD ≥1.0 cm with CILN and/or PALN MAD 0.5-1.0 cm were risk factors for CILN and/or PALN metastasis.
      Conclusion: Patients with MAD ≥1.0 cm and SCC-Ag ≥ 5.2 ng/mL, as well as high risk factors for CILN and/or PALN metastasis, should undergo resection of enlarged lymph nodes below the common iliac gland and lymphadenectomy of CILN/PALN to reduce tumor burden and to clarify lymph node metastasis status for accurate guidance in follow-up treatment. Patients with MAD < 1.0 cm and SCC-Ag < 5.2 ng/mL may be treated with chemoradiotherapy directly based on imaging, given the low lymph node metastasis rate.
    • References:
      Ai Zheng. 2005 Oct;24(10):1261-6. (PMID: 16219145)
      J Gynecol Oncol. 2018 Jan;29(1):e11. (PMID: 29185269)
      J Clin Oncol. 1996 Jan;14(1):111-8. (PMID: 8558185)
      Int J Gynecol Cancer. 2013 Nov;23(9):1675-83. (PMID: 24172103)
      Cancer. 1999 Apr 1;85(7):1547-54. (PMID: 10193945)
      Best Pract Res Clin Obstet Gynaecol. 2015 Aug;29(6):870-83. (PMID: 26043964)
      Cancer. 2008 May 1;112(9):1954-63. (PMID: 18338811)
      BJOG. 2017 Jun;124(7):1089-1094. (PMID: 28128517)
      Gynecol Oncol. 2017 Jan;144(1):40-45. (PMID: 27855989)
      Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2014 Feb;36(1):73-8. (PMID: 24581133)
      J Gynecol Oncol. 2015 Jul;26(3):171-8. (PMID: 25925292)
      Asian Pac J Cancer Prev. 2015;16(11):4719-22. (PMID: 26107230)
      Clin Radiol. 2014 Dec;69(12):1235-43. (PMID: 25439186)
      Cancer. 1998 Jun 1;82(11):2241-8. (PMID: 9610705)
      Br J Radiol. 2015 Aug;88(1052):20150063. (PMID: 26023947)
      Am J Obstet Gynecol. 2010 Aug;203(2):156.e1-5. (PMID: 20435285)
      Int J Gynecol Cancer. 2017 Nov;27(9):1935-1942. (PMID: 28914639)
      Gynecol Oncol. 1990 Sep;38(3):425-30. (PMID: 2227556)
      Obstet Gynecol. 2019 Jul;134(1):49-57. (PMID: 31188324)
      Clin Nucl Med. 2018 Nov;43(11):793-801. (PMID: 30153151)
      PLoS One. 2017 Dec 11;12(12):e0186165. (PMID: 29227998)
      J Minim Invasive Gynecol. 2018 Nov - Dec;25(7):1142-1143. (PMID: 29427781)
      Gynecol Obstet Invest. 2017;82(3):209-222. (PMID: 28183074)
    • Contributed Indexing:
      Keywords: Cervical neoplasm; Computed tomography (CT); Retroperitoneal lymph node; Squamous cell carcinoma antigen (SCC-Ag)
    • Accession Number:
      0 (Antigens, Neoplasm)
      0 (Serpins)
      0 (squamous cell carcinoma-related antigen)
    • Publication Date:
      Date Created: 20210502 Date Completed: 20210806 Latest Revision: 20240809
    • Publication Date:
      20240809
    • Accession Number:
      PMC8088051
    • Accession Number:
      10.1186/s12885-021-08208-6
    • Accession Number:
      33933005