Distal external iliac lymph nodes in early cervical cancer

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

doi:10.1016/s0029-7844(99)00310-5

Cited by 18 publications

(14 citation statements)

References 10 publications

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“…These results suggest that CILs have a greater impact on the development of LLL than PALA. CILs are located between the deep circumflex iliac vein and the femoral canal, and are involved in draining the lymph nodes of the lower limbs in the pelvis [13, 31]. Therefore, CILs ought to be preserved for patients at lower-risk of CIL metastasis [12, 13, 31].…”

Section: Discussionmentioning

confidence: 99%

“…CILs are located between the deep circumflex iliac vein and the femoral canal, and are involved in draining the lymph nodes of the lower limbs in the pelvis [13, 31]. Therefore, CILs ought to be preserved for patients at lower-risk of CIL metastasis [12, 13, 31]. Positron emission tomography-computed tomography and sentinel lymph node biopsy may be investigated further in order to determine an appropriate lymph node dissection range [5, 32, 33].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study

et al. 2017

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BackgroundLower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence.MethodsPelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk.ResultsThe cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m2 (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030–2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126–4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148–5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120–2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3–6) and low-risk (scores 0–2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440–3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9–62.1%] for the high-risk group and 28.9% [95% CI, 21.1–38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0.632 at 3 years, 0.640 at 5 years, and 0.637 at 10 years.ConclusionBMI ≥25 kg/m2, PLA + PALA, lymphocyst formation, and postoperative radiation therapy are significant predictive factors for LLL. Our prediction model may be useful for identifying patients at risk of LLL following lymphadenectomy. Providing an intensive therapeutic strategy for high-risk patients may help reduce the incidence of LLL and conserve the quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study

et al. 2017

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“…It is widely known that salvage chemotherapy and surgery were the only two methods that have been commonly used to treat ILNM in the clinical settings. However, each method has its only limitations4. Regimens for salvage chemotherapy have to depend on histopathology of the primary tumor, and the results are disappointing.…”

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confidence: 99%

“…Regimens for salvage chemotherapy have to depend on histopathology of the primary tumor, and the results are disappointing. Surgery is considered as a curative option for some isolated metastases, but the lymphadenectomy sometimes can be difficult because of disease extent, involvement of critical structures and perioperative complications4. Therefore, there is a critical requirement to find other available treatments that are effective, safe and non-invasive for these lesions.…”

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confidence: 99%

Stereotactic body radiation therapy induces fast tumor control and symptom relief in patients with iliac lymph node metastasis

Wang

Zhuang

et al. 2016

Sci Rep

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The CyberKnife is a robotic stereotactic body radiotherapy (SBRT) system which has shown promising results for many malignances with good efficacy and low toxicity. This study aims to evaluate the response and local control (LC) obtained with CyberKnife in the management of iliac lymph node metastases (ILNM). Twenty-two patients with 27 ILNM were treated by CyberKnife from May 2010 to May 2016. Median follow-up time was 33 months (8–97). The complete response, partial response, stable disease and progression disease rates were 37.0%, 48.0%, 7.5% and 7.5% respectively. The 1-, 2-, and 3-year LC rates were all 90.6%, and overall survival rates were 78.8%, 60.6%, and 43.3% respectively. All patients with pelvic pain and ureter obstruction achieved good and fast symptom relief, while leg edema persisted in 2 patients. The general treatment tolerance was acceptable and no severe toxicities were reported. No factors were found correlated with local failure. While overall survival (OS) was better for patients who had received a total dose more than 30 Gy or prior systemic treatment, and whose symptoms were relieved. Taken together, CyberKnife is an effective therapeutic option for ILNM, providing high LC rate and good symptom relief with minimal toxicity.

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“…9,10 Then, some experts also suggest that the deep circumflex iliac vein is an appropriate landmark for the distal limit of external iliac lymphadenectomy. 10,11 Our study was to describe the incidence and distribution pattern of metastatic lymph nodes in patients with stage IA to IIA cervical cancer to determine whether dissection of CINDEIN has a role in surgery of these patients.…”

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confidence: 99%

Distribution Pattern of Circumflex Iliac Node Distal to the External Iliac Node Metastasis in Stage IA to IIA Cervical Carcinoma

Yin

Sheng

et al. 2014

Int J Gynecol Cancer

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Distal external iliac lymph nodes in early cervical cancer

Abstract: The deep circumflex iliac vein was an appropriate landmark for the caudal limit of external iliac lymphadenectomy.

Cited by 18 publications

References 10 publications

Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study

Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study

Stereotactic body radiation therapy induces fast tumor control and symptom relief in patients with iliac lymph node metastasis

Distribution Pattern of Circumflex Iliac Node Distal to the External Iliac Node Metastasis in Stage IA to IIA Cervical Carcinoma

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