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@article{2247611,
author = {Dostalek, Lukas and Benešová, Klára and Klat, Jaroslav and Kim, Sarah H and Falconer, Henrik and Kostun, Jan and Ricardo, dos Reis and Zapardiel, Ignacio and Landoni, Fabio and Ortizj, David Isla and van Lonkhuijzen, Luc R C W and Lopez, Aldo and Odetto, Diego and Borcinova, Martina and Jarkovský, Jiří and Salehi, Sahar and Nemejcova, Kristyna and Bajsova, Sylva and Park, Kay J and Javurkova, Veronika and AbuandRustum, Nadeem R and Dundr, Pavel and Cibula, David},
article_location = {SAN DIEGO},
article_number = {January 2023},
doi = {http://dx.doi.org/10.1016/j.ygyno.2022.11.017},
keywords = {Micrometastasis; Cervical cancer; Low volume metastasis; Disease-free survival; Histopathological ultrastaging; Isolated tumor cells; Sentinel lymph node; Macrometastasis; Classification; Prognosis},
language = {eng},
issn = {0090-8258},
journal = {Gynecologic Oncology},
title = {Stratification of lymph node metastases as macrometastases, micrometastases, or isolated tumor cells has no clinical implication in patients with cervical cancer: Subgroup analysis of the SCCAN project},
url = {https://www.sciencedirect.com/science/article/pii/S0009898122014279},
volume = {168},
year = {2023}
}
TY - JOUR
ID - 2247611
AU - Dostalek, Lukas - Benešová, Klára - Klat, Jaroslav - Kim, Sarah H - Falconer, Henrik - Kostun, Jan - Ricardo, dos Reis - Zapardiel, Ignacio - Landoni, Fabio - Ortizj, David Isla - van Lonkhuijzen, Luc R C W - Lopez, Aldo - Odetto, Diego - Borcinova, Martina - Jarkovský, Jiří - Salehi, Sahar - Nemejcova, Kristyna - Bajsova, Sylva - Park, Kay J - Javurkova, Veronika - Abu-Rustum, Nadeem R - Dundr, Pavel - Cibula, David
PY - 2023
TI - Stratification of lymph node metastases as macrometastases, micrometastases, or isolated tumor cells has no clinical implication in patients with cervical cancer: Subgroup analysis of the SCCAN project
JF - Gynecologic Oncology
VL - 168
IS - January 2023
SP - 151-156
EP - 151-156
PB - ACADEMIC PRESS INC ELSEVIER SCIENCE
SN - 00908258
KW - Micrometastasis
KW - Cervical cancer
KW - Low volume metastasis
KW - Disease-free survival
KW - Histopathological ultrastaging
KW - Isolated tumor cells
KW - Sentinel lymph node
KW - Macrometastasis
KW - Classification
KW - Prognosis
UR - https://www.sciencedirect.com/science/article/pii/S0009898122014279
N2 - Background. In cervical cancer, presence of lymph-node macrometastases (MAC) is a major prognostic factor and an indication for adjuvant treatment. However, since clinical impact of micrometastases (MIC) and isolated tumor-cells (ITC) remains controversial, we sought to identify a cut-off value for the metastasis size not associ-ated with negative prognosis.Methods. We analyzed data from 967 cervical cancer patients (T1a1L1-T2b) registered in the SCCAN (Surveil-lance in Cervical CANcer) database, who underwent primary surgical treatment, including sentinel lymph-node (SLN) biopsy with pathological ultrastaging. The size of SLN metastasis was considered a continuous variable and multiple testing was performed for cut-off values of 0.01-1.0 mm. Disease-free survival (DFS) was compared be-tween N0 and subgroups of N1 patients defined by cut-off ranges.Results. LN metastases were found in 172 (18%) patients, classified as MAC, MIC, and ITC in 79, 54, and 39 pa-tients, respectively. DFS was shorter in patients with MAC (HR 2.20, P = 0.003) and MIC (HR 2.87, P < 0.001), while not differing between MAC/MIC (P = 0.484). DFS in the ITC subgroup was neither different from N0 (P = 0.127) nor from MIC/MAC subgroups (P = 0.449). Cut-off analysis revealed significantly shorter DFS com-pared to N0 in all subgroups with metastases >= 0.4 mm (HR 2.311, P = 0.04). The significance of metastases <0.4 mm could not be assessed due to limited statistical power (<80%). We did not identify any cut-off for the size of metastasis with significantly better prognosis than the rest of N1 group.Conclusions. In cervical cancer patients, the presence of LN metastases >= 0.4 mm was associated with a signif-icant negative impact on DFS and no cut-off value for the size of metastasis with better prognosis than N1 was found. Traditional metastasis stratification based on size has no clinical implication.
ER -
DOSTALEK, Lukas, Klára BENEŠOVÁ, Jaroslav KLAT, Sarah H KIM, Henrik FALCONER, Jan KOSTUN, dos Reis RICARDO, Ignacio ZAPARDIEL, Fabio LANDONI, David Isla ORTIZJ, Luc R C W VAN LONKHUIJZEN, Aldo LOPEZ, Diego ODETTO, Martina BORCINOVA, Jiří JARKOVSKÝ, Sahar SALEHI, Kristyna NEMEJCOVA, Sylva BAJSOVA, Kay J PARK, Veronika JAVURKOVA, Nadeem R ABU-RUSTUM, Pavel DUNDR a David CIBULA. Stratification of lymph node metastases as macrometastases, micrometastases, or isolated tumor cells has no clinical implication in patients with cervical cancer: Subgroup analysis of the SCCAN project. \textit{Gynecologic Oncology}. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2023, roč.~168, January 2023, s.~151-156. ISSN~0090-8258. Dostupné z: https://dx.doi.org/10.1016/j.ygyno.2022.11.017.
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