Aortic node metastases with negative pelvic nodes in cervical cancer

Deppe, Gunter; Lubicz, Stephane; Galloway, Booker T.; Thomas, William J.; Heredia, Raul

doi:10.1002/1097-0142(19840101)53:1<173::aid-cncr2820530130>3.0.co;2-8

Cited by 25 publications

(6 citation statements)

References 2 publications

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“…Assessment of PAN status is essential in deciding whether or not irradiation to the paraaortic area should be employed. Our results suggest that PAN metastasis from cervical carcinoma occurs secondarily to extensive lymphatic metastasis in the pelvic area, although this does not exclude the possibility of direct PAN metastasis 15. A strong possibility of PAN metastasis could be predicted by examining the distribution and number of PLNs involved.…”

Section: Discussionmentioning

confidence: 57%

Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy

Sakuragi

Satoh

Takeda

et al. 1999

Cancer

335

194

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BACKGROUND The incidence and distribution pattern of retroperitoneal lymph node metastasis in patients with cervical carcinoma should be investigated based on data from systematic pelvic lymph node (PLN) and paraaortic lymph node (PAN) dissection, so that a basis can be established for determining the site of selective lymph node dissection or sampling. METHODS A total of 208 patients with Stages IB, IIA, and IIB cervical carcinoma who underwent radical hysterectomy and systematic pelvic and PAN dissection were investigated for lymph node metastasis and histopathologic risk factors for lymph node metastasis. RESULTS Fifty‐three patients (25.5%) had lymph node metastasis. The obturator lymph nodes were most frequently involved, with a rate of 18.8% (39/208). Forty‐nine of 53 node‐positive patients had lymph node metastasis in the obturator, internal iliac, or common iliac lymph nodes. Of 26 solitary lymph node metastases confined to one node group, 18 were in the obturator, 3 in the internal iliac, 3 in the parametrial, and 2 in the common iliac lymph nodes. A multiple logistic regression analysis revealed that deep cervical stromal invasion and lymph‐vascular space invasion were related to PLN metastasis. It was also shown that metastasis to bilateral PLNs (excluding the common iliac lymph nodes) as well as metastasis to the common iliac lymph nodes were significantly related to PAN metastasis. CONCLUSIONS The results of this study suggest that the obturator lymph nodes can be sentinel lymph nodes of cervical carcinoma. PAN metastasis appears to occur secondarily to wide‐spread PLN metastasis. These results provide a basis for determining the site of selective lymph node dissection and for estimating the existence of PAN metastasis from the pattern of metastasis in PLN in patients with cervical carcinoma. Cancer 1999;85:1547–54. © 1999 American Cancer Society.

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Section: Discussionmentioning

confidence: 57%

Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy

Sakuragi

Satoh

Takeda

et al. 1999

Cancer

335

194

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“…23 We could not evaluate this possibility in our material because in our protocol metastases in regional lymph nodes were an inclusion criterion for para-aortic dissection. However, in one patient we found HPV DNA in the CIP lymph nodes although neither HPV DNA nor metastases were present in the EIO nodes.…”

Section: Discussionmentioning

confidence: 99%

HPV and histological status of pelvic lymph node metastases in cervical cancer: a prospective study

Łukaszuk

Liss²,

Woźniak³

et al. 2004

J Clin Pathol

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Aims: The purpose of this prospective study was to describe the incidence and distribution pattern of human papillomavirus (HPV) DNA in intraoperative dissected lymph nodes and to relate this to the pathological confirmation of metastasis. Methods: Samples of primary cervical cancer lesions and dissected lymph nodes were obtained from women undergoing surgical treatment. The presence of HPV DNA was detected by the polymerase chain reaction. Results: Tissue from 79 tumours and 365 lymph nodes was analysed. Metastasis to the lymph nodes was found in 19 cases. Metastasis correlated with the volume of the primary lesion, the depth of cervical and vaginal invasion, and with invasion of the corpus. HPV DNA was found in 60 of the primary lesions and 31 of the lymph nodes. The presence of HPV DNA in the lymph nodes correlated with the volume of the primary lesion and vaginal invasion. Conclusions: The incidence of HPV DNA in lymph nodes is twice as high as that of histopathologically confirmed metastases. The risk of the presence of HPV DNA and histopathologically confirmed metastases in lymph nodes is related to certain features of the primary tumour.C arcinoma of the uterine cervix, the fourth most common cancer among women worldwide, is one of the most important health issues for women. Infection with certain oncogenic types of human papillomavirus (HPV) is considered a prerequisite for the development of the disease.1 The involvement of HPV in the development of cervical cancer is well established.2 3 In recent years, there has been growing interest in HPV because of the emerging evidence of its oncogenic potential, particularly in the anogenital tract.1 4 The prevalence of HPV infection in cervical cancer tissue is estimated to be in the range of 90%, and according to the Eurogin Committee it may be up to 99%. 6In a previous study, we found a lower prevalence in our region. 7Early detection of the preinvasive states of the disease leads to uncomplicated treatment and a good survival rate. Unfortunately, in Poland most cervical cancers are detected at advanced, invasive stages. The patients mostly undergo radical hysterectomy (Piver III). The survival of patients after radical hysterectomy depends on several factors, such as tumour size, histological tumour type, lymph node involvement, and the surgeon's skill. 8 9 The most important predictive factor seems to be the metastasis status of pelvic lymph nodes. Nevertheless, there are some patients with histopathologically negative pelvic nodes who unexpectedly have recurrences and a short life expectancy. Several studies have focused on the correlation between HPV status and lymph node involvement.1 10-12 Most have involved hybridisation 1 13 or the polymerase chain reaction (PCR) to detect HPV-16 and HPV-18. ''Unfortunately, in Poland most cervical cancers are detected at advanced, invasive stages''The purpose of our prospective study was to describe the incidence and distribution pattern of HPV DNA in intraoperatively dissected lymph nodes and pathologically confirme...

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“…The incidence of lymph node metastasis increases with FIGO stage (19–20,27–33). The reported rate of PALN metastasis range from 5 to 33% in women with locally advanced cervical cancer (12–14).…”

Section: Discussionmentioning

confidence: 99%

Upper margin of para‐aortic lymphadenectomy in cervical cancer

Ouldamer

Fichet-Djavadian

Marret

et al. 2012

Acta Obstet Gynecol Scand

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Patients with early stage cervical cancer routinely undergo pelvic lymphadenectomy. A para-aortic lymphadenectomy is only performed in the setting of grossly enlarged lymph nodes. In patients with locally advanced disease, a para-aortic lymphadenectomy is indicated particularly when pelvic nodes are suspicious for disease on preoperative imaging. There is no consensus about the extent of para-aortic lymph node dissection in these patients. We reviewed relevant literature to determine the extension of para-aortic lymphadenectomy in patients with cervical cancer in order to establish whether lymph node dissection up to the inferior mesenteric artery or higher to the level of renal vessels should be performed. We performed a systematic search (PubMed; up to June 2011) to review systematic complete para-aortic lymphadenectomy. According to our search, eight women (1.09%) had isolated para-aortic node metastases, of which two had only lymph node metastases above the inferior mesenteric artery.

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Aortic node metastases with negative pelvic nodes in cervical cancer

Abstract: A case of invasive squamous cell carcinoma of the cervix with aortic lymph node metastases in the absence of pelvic lymph node metastases is described. The spread of squamous cell carcinoma of the cervix is briefly reviewed. Cancer 53:173‐175 1984.

Cited by 25 publications

References 2 publications

Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy

Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy

HPV and histological status of pelvic lymph node metastases in cervical cancer: a prospective study

Upper margin of para‐aortic lymphadenectomy in cervical cancer

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