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

J 2023

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

DOSTALEK, Lukas, Klára BENEŠOVÁ, Jaroslav KLAT, Sarah H KIM, Henrik FALCONER et. al.

Základní údaje

Originální název

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

Autoři

DOSTALEK, Lukas (203 Česká republika), Klára BENEŠOVÁ (203 Česká republika, domácí), Jaroslav KLAT (203 Česká republika), Sarah H KIM, Henrik FALCONER, Jan KOSTUN (203 Česká republika), dos Reis RICARDO, Ignacio ZAPARDIEL, Fabio LANDONI, David Isla ORTIZJ, Luc R C W VAN LONKHUIJZEN, Aldo LOPEZ, Diego ODETTO, Martina BORCINOVA, Jiří JARKOVSKÝ (203 Česká republika, domácí), Sahar SALEHI, Kristyna NEMEJCOVA, Sylva BAJSOVA (203 Česká republika), Kay J PARK, Veronika JAVURKOVA (203 Česká republika), Nadeem R ABU-RUSTUM, Pavel DUNDR (203 Česká republika) a David CIBULA (203 Česká republika, garant)

Vydání

Gynecologic Oncology, SAN DIEGO, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2023, 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

Odkazy

URL

Impakt faktor

Impact factor: 4.700 v roce 2022

Kód RIV

RIV/00216224:14110/23:00130194

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.ygyno.2022.11.017

UT WoS

000891635900010

Klíčová slova anglicky

Micrometastasis; Cervical cancer; Low volume metastasis; Disease-free survival; Histopathological ultrastaging; Isolated tumor cells; Sentinel lymph node; Macrometastasis; Classification; Prognosis

Štítky

14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 18. 1. 2023 13:38, Mgr. Tereza Miškechová

Anotace

V originále

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.

Citovat

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. 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.

@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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