Distal External Iliac Lymph Nodes in Early Cervical Cancer

Hoffman, Mitchel S.; Parsons, Michael T.; Gunasekaran, Sivaselvi; Cavanagh, Denis

doi:10.1097/00006250-199909000-00013

Cited by 8 publications

(10 citation statements)

References 8 publications

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“…SFNs are located in the adipose tissue that is most distal to the external iliac nodes, which is a hub for the anterior route [16,17], which may explain why SFNs have commonly been included in the regional lymph nodes for cervical cancer. On the other hand, the lymph nodes most frequently involved in cervical malignancies are reported to be internal iliac, obturator, external iliac, and common iliac nodes [17][18][19]. More importantly, solitary lymph node metastases are detected in very limited nodes: obturator, internal iliac, cardinal ligament, and common iliac nodes; SFN metastases are rarely encountered in operative cases [17,18,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the lymph nodes most frequently involved in cervical malignancies are reported to be internal iliac, obturator, external iliac, and common iliac nodes [17][18][19]. More importantly, solitary lymph node metastases are detected in very limited nodes: obturator, internal iliac, cardinal ligament, and common iliac nodes; SFN metastases are rarely encountered in operative cases [17,18,20,21]. Indeed, it has been reported that SFN metastases are accompanied with multiple lymph node metastases, and only 8% of patients with any positive regional nodes have SFN metastases [18].…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, solitary lymph node metastases are detected in very limited nodes: obturator, internal iliac, cardinal ligament, and common iliac nodes; SFN metastases are rarely encountered in operative cases [17,18,20,21]. Indeed, it has been reported that SFN metastases are accompanied with multiple lymph node metastases, and only 8% of patients with any positive regional nodes have SFN metastases [18]. Moreover, SFNs are seldom identified as sentinel lymph nodes in cervical cancer [22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for lower-limb lymphedema after surgery for cervical cancer

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk factors for lower-limb lymphedema after surgery for cervical cancer

et al. 2011

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“…No metastases were detected to the sacral or internal and external inguinal nodes, which corresponds with the report that the most distal circumflex iliac nodes were not found to be positive as isolated nodal metastases in early cervical cancer. 19 Buchsbaum showed that, in the routes of lymphatic flow from the uterine cervix, the most crucial one is the channel directed laterally to the obturator, inter-iliac and common iliac nodes, the second is the anterior channels which terminate in the external iliac, and the third passes posteriorly to reach the common iliac, sacral and para-aortic nodes. 19 Reiffensthul et al described that the routes can be divided into three main routes: the lateral trunk runs through the lateral parametrium to the obturator nodes, the anterior trunk through the vesicouterine ligament into the inter-iliac nodes and the posterior trunk through the sacrouterine ligament and ureter into the presacral and para-aortic nodes.…”

Section: Discussionmentioning

confidence: 99%

Re‐consideration of lymphadenectomy for stage Ib1 cervical cancer

Kato¹,

Todo²,

Suzuki³

et al. 2012

J of Obstet and Gynaecol

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Aim: Because of less frequent lymph node metastasis and parametrial involvement, patients with stage Ib1 cervical cancer may benefit from a curtailment of surgery. We retrospectively investigated the distribution of lymph node metastasis in stage Ib1 patients. After comparing the data with that of higher stages and sentinel lymph node navigation (SLNN), the appropriate extent of lymphadenectomy (LA) in stage Ib1 disease was newly suggested. Method: A total of 303 patients underwent a radical hysterectomy with LA and the region-specific rate of node metastasis was obtained. SLNN was performed for 50 patients using 99mTc phytate injection into the cervix and intra-operative detection by a gamma-probe. Results: The rate of node metastasis and the average number of nodes removed, respectively, were: 23/189 (12.2%), 65.2 in stage Ib1; 14/47 (29.8%), 70.1 in stage Ib2; 7/20 (35.0%), 78.2 in stage IIa; and 26/47 (55.3%), 69.1 in stage IIb. Lymph node metastasis in stage Ib1 was prevalent in the obturator (Ob) (9.5%), inter-iliac (Ii) (4.9%), superficial common iliac (Sc) (2.3%), cardinal (Cd) (2.2%) and external iliac (Ei) (1.7%) nodes. In patients with upper stage disease, lymph node metastasis could occur in all lymph nodes. In stage Ib1 patients, the sentinel nodes were assigned only to the Ob, Ii, Sc and Ei nodes, being identical with frequent metastatic sites in stage Ib1 (excluding Cd). Conclusion:The extent of LA can be routinely completed with the removal of Ob, Ii, Ei, Sc and Cd nodes, which may provide a higher quality of life, including the reduction of lymphedema by preventing the removal of the inguinal nodes.

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“…These lymph nodes are also referred to as the lateral suprafemoral nodes [7], circumflex iliac nodes [8], Jackson's node [9], and the distal external iliac nodes [10]. In almost all patients, these nodes are located in the enlarged adipose tissue immediately above the pelvic wall, which attracts surgeons' attention; therefore, the lymph nodes of this group are commonly removed when the external iliac vessels are exposed for a systematic lymphadenectomy.…”

Section: Introductionmentioning

confidence: 99%