2012
Bilateral ultrastaging of sentinel lymph node in cervical cancer: Lowering the false-negative rate and improving the detection of micrometastasis
CIBULA, David, Nadeem R. ABU-RUSTUM, Ladislav DUŠEK, Jiří SLÁMA, Michal ZIKÁN et. al.Základní údaje
Originální název
Bilateral ultrastaging of sentinel lymph node in cervical cancer: Lowering the false-negative rate and improving the detection of micrometastasis
Autoři
CIBULA, David (203 Česká republika, garant), Nadeem R. ABU-RUSTUM (840 Spojené státy), Ladislav DUŠEK (203 Česká republika, domácí), Jiří SLÁMA (203 Česká republika), Michal ZIKÁN (203 Česká republika), Afra ZAAL (528 Nizozemské království), Libor ŠEVČÍK (203 Česká republika), Gemma KENTER (528 Nizozemské království), Denis QUERLEU (250 Francie), Robert JACH (616 Polsko), Anne-Sophie BATS (250 Francie), Grzegorz DYDUCH (616 Polsko), Peter GRAF (203 Česká republika), Jaroslav KLAT (203 Česká republika), Chris J.L.M. MEIJER (528 Nizozemské království), Eliane MERY (250 Francie), Rene VERHEIJEN (528 Nizozemské království) a Ronald P. ZWEEMER (528 Nizozemské království)
Vydání
Gynecologic Oncology, 2012, 0090-8258
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30200 3.2 Clinical medicine
Stát vydavatele
Česká republika
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.929
Kód RIV
RIV/00216224:14110/12:00062393
Organizační jednotka
Lékařská fakulta
UT WoS
000311528500005
Klíčová slova anglicky
Cervical cancer; Sentinel lymph node; Staging
Změněno: 23. 4. 2013 00:19, Ing. Mgr. Věra Pospíšilíková
Anotace
V originále
Objective. To evaluate the sensitivity of sentinel node (SN) ultrastaging and to define parameters that may reduce the overall false-negative rate in women with early-stage cervical cancer. Methods. We analyzed data from a large retrospective multicenter cohort group with FIGO stages IA–IIB cervical cancer in whom at least one SN was identified and systematic pelvic lymphadenectomy was uniformly performed. All who were SN negative by initial evaluation were subjected to ultrastaging. Results. In all, 645 patients were evaluable. SN were detected bilaterally in 72% of cases and unilaterally in 28%. Patients with optimal bilateral SN detection were significantly more likely to have any metastasis detected (33.3% vs. 19.2%; Pb0.001) as well as micrometastasis detected in their SN (39.6% vs. 11.4%). SN ultrastaging resulted in a low overall false-negative rate of 2.8% (whole group) and an even lower false-negative rate of 1.3% for patients with optimal bilateral mapping. Patients with false-negative SN after ultrastaging had a higher prevalence of LVSI and more frequent unilateral SN detection. Sensitivity of SN ultrastaging was 91% (95% CI: 86%–95%) for the whole group and 97% (95% CI: 91%–99%) in the subgroup with bilateral SN detection. Conclusion. These data confirm previous observations that optimal bilateral SN detection substantially decreases the false negative rate of SN ultrastaging and increases detection of micrometastasis. In patients with bilateral SN detection, the sensitivity of SN ultrastaging is not reduced in more advanced stages of the disease. SN mapping and ultrastaging should become standard practice in the surgical management of early-stage cervical cancer.