J 2016

Risk of micrometastases in non-sentinel pelvic lymph nodes in cervical cancer

CIBULA, D.; M. ZIKAN; J. SLAMA; D. FISCHEROVA; R. KOCIAN et al.

Základní údaje

Originální název

Risk of micrometastases in non-sentinel pelvic lymph nodes in cervical cancer

Autoři

CIBULA, D.; M. ZIKAN; J. SLAMA; D. FISCHEROVA; R. KOCIAN; A. GERMANOVA; A. BURGETOVA; Ladislav DUŠEK; P. DUNDR; M. GREGOVA a K. NEMEJCOVA

Vydání

Gynecologic Oncology, San Diego, Academic Press Inc. 2016, 0090-8258

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.959

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/16:00091060

Organizační jednotka

Lékařská fakulta

UT WoS

000384391800014

EID Scopus

2-s2.0-84990250643

Klíčová slova anglicky

Sentinel lymph node; Pathologic ultrastaging; Micrometastasis

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 6. 1. 2017 11:12, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Objective. A high sensitivity of sentinel lymph nodes (SLN) for pelvic lymph node (LN) staging has been repeatedly shown in patients with cervical cancer. However, since only SLN are evaluated by pathologic ultrastaging, the risk of small metastases, including small macrometastases (MAC) and micrometastases (MIC), in non-SLN is unknown. This can be a critical limitation for the oncological safety of abandoning a pelvic lymphadenectomy. Methods. The patients selected for the study had cervical cancer and were at high risk for LN positivity (stage IB-IIA, biggest diameter >= 3 cm). The patients had no enlarged or suspicious LN on pre-operative imaging; SLNs were detected bilaterally and were negative on intra-operative pathologic evaluation. All SLNs and all other pelvic LNs were examined using an ultrastaging protocol and processed completely in intervals of 150 mu m. Results. In all, 17 patients were enrolled into the study. The mean number of removed pelvic LNs was 30. A total of 573 pelvic LNs were examined through ultrastaging protocol (5762 slides). Metastatic involvement was detected in SLNs of 8 patients (1 x MAC; 4x MIC; 3x ITC) and in non-SLNs in 2 patients (2x MIC), In both cases with positive pelvic non-SLNs, there were found MIC in ipsilateral SLNs. No metastasis in pelvic nonSLNs was found by pathologic ultrastaging in any of the patients with negative SLN Side-specific sensitivity was 100% for MAC and MIC. There was one case of ITC detected in non-SLN, negative ipsilateral SLN, but MIC in SLN on the other pelvic side. Conclusions. After processing all pelvic LNs by pathologic ultrastaging, there were found no false-negative cases of positive non-SLN (MAC or MIC) and negative SLN. SLN ultrastaging reached 100% sensitivity for the presence of both MAC and MIC in pelvic LNs.