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RESEARCH PRODUCT

Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study

Gabriella FerrandinaGabriella FerrandinaAlfredo ErcoliEnrico VizzaFrancesco FanfaniLuigi Pedone AnchoraCarolina BottoniAnna FagottiAnna FagottiValerio GallottaPierandrea De IacoGiovanni ScambiaGiovanni ScambiaVito ChianteraGiacomo Corrado

subject

AdultAdenocarcinoma; Adult; Aged; Aged 80 and over; Carcinoma Squamous Cell; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Middle Aged; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Uterine Cervical Neoplasms; Young Adult; Lymph Node Excision; Sentinel Lymph Node Biopsy0301 basic medicinemedicine.medical_specialtySentinel lymph nodeUterine Cervical NeoplasmsAdenocarcinomaLogistic regressionYoung Adult03 medical and health sciences0302 clinical medicineRisk FactorsmedicineHumansStage (cooking)Large-Scale Retrospective Study Sentinel lymph node (SLN) biopsy Lymphadenectomy (LND) early-stage cervical cancer (ECC)Lymph nodeAgedRetrospective StudiesAged 80 and overCervical cancerSentinel Lymph Node Biopsybusiness.industryRetrospective cohort studyMiddle AgedPrognosismedicine.diseaseSurgerySurvival Ratecervical cancer lymph nodes metastasesDissectionExact testSettore MED/40 - GINECOLOGIA E OSTETRICIA030104 developmental biologymedicine.anatomical_structureOncologyLymphatic Metastasis030220 oncology & carcinogenesisSurgery; OncologyCarcinoma Squamous CellLymph Node ExcisionFemaleSurgeryRadiologybusinessFollow-Up Studies

description

BACKGROUND: Sentinel lymph node (SLN) biopsy has emerged as one of the most appreciated techniques for reducing the rate of complete lymph node dissection (LND) performed in patients with early-stage cervical cancer (ECC). However, its performances are still a matter of debate and, to improve them, international guidelines recommend performing at least unilateral LND in case of SLN mapping. In a prior study, we identified a group of patients without evidence of lymph node metastasis (LNM). Our objective is to define a precise risk of LNM for each ECC patient in order to significantly tailor surgery for ECC. METHODS: Clinical and pathological data of ECC patients were retrospectively collected by eight Italian institutions. Chi-square test or Fisher's exact test along with logistic regression analysis was used to determine the association of each variable between patients with or without LNM. Results of logistic regression have been used as a basis to calculate the probability to harboring LNM. RESULTS: A total of 463 ECC patients were identified. No LNM was detected among the 161 (34.8%) patients who met the criteria and were defined as Very Low Risk. In the other 302 patients, the precise risk of LNM was calculated, and it was <1% in 31 (10.3%) patients. CONCLUSIONS: Defining the precise risk of LNM could lead to proper selection of patients in whom any lymph nodal procedure, including SLN, could be avoided.

yearjournalcountryeditionlanguage
2017-01-01Annals of Surgical Oncology
https://doi.org/10.1245/s10434-017-5917-0