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RESEARCH PRODUCT

Prevalence of lymph nodes in the parametrium of radical vaginal trachelectomy (RVT) specimen

Dorothee SpeiserK. HasenbeinLars MorawietzMalgorzata LanowskaChristhardt KöhlerGert RäberAchim SchneiderMandy ManglerVito ChianteraArne Sikora

subject

Adultmedicine.medical_specialtyUterine Cervical NeoplasmBroad LigamentEarly stage cervical cancerUterine Cervical NeoplasmsHistopathologyRadical vaginal trachelectomyTrachelectomyGynecologic oncologyMetastasisGynecologic Surgical ProceduresGynecologic Surgical ProcedureParametriummedicinePrevalenceHumansCervical cancerbusiness.industryParametrialLymph NodeObstetrics and GynecologyLymphatic Metastasimedicine.diseaseImmunohistochemistrySurgeryEarly stage cervical cancer; Radical vaginal trachelectomy; Parametrial resectionmedicine.anatomical_structureParametrial lymph nodeOncologyLymphatic MetastasisParametrial resectionHistopathologyFemaleLymph NodesLymphbusinessHuman

description

Objective: In order to evaluate radicality in fertility preserving surgery in women with early invasive cervical cancer we analyzed the parametrium of specimens of patients treated by radical vaginal trachelectomy for the presence of lymph nodes. We tried to identify morphologic factors associated with the presence of parametrial lymph nodes. Methods: We analyzed surgical specimens of 112 patients who underwent radical trachelectomy between June 2004 and April 2009 at the Department of Gynecologic Oncology at Charité Campus Benjamin Franklin and Campus Mitte. All parametrial tissue was step sectioned and a total of 1878H&E stained histological sections were analyzed. Results: In 8 patients (7.1%) a total of 13 lymph nodes were detected. Five lymph nodes in four patients had been primarily detected by routine histological examination. In one of these patients (0.9%) a 2 mm lymph node metastasis was found. Serial sectioning revealed additional seven lymph nodes in four patients. The thickness of parametrium correlated significantly with the presence of lymph nodes in the parametrium. Conclusion: The presence of small lymph nodes in the parametrium of specimens of radical trachelectomy is low. In patients with early-stage cervical cancer, the incidence of metastasis is less than 1%. Preoperative assessment of the volume of the parametrium may indicate which patients need parametrial resection. © 2011 Elsevier Inc. All rights reserved.

yearjournalcountryeditionlanguage
2011-01-01
10.1016/j.ygyno.2011.01.011http://hdl.handle.net/10447/165592