Lymph Node Metastases and Prognosis in Patients With Stage IA sub 2 Cervical Cancer

Buckley, S.L.; Tritz, Denise M.; Le, Linda Van; Higgins, Robert V.; Sevin, Bernd‐Uwe; Ueland, Frederick R.; DePriest, Paul D.; Gallion, Holly H.; Bailey, Candice L.; Fowler, Wesley C.; Averette, Hervy E.; Nagell, J.R. van

doi:10.1097/00006254-199702000-00011

Cited by 21 publications

(32 citation statements)

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“…In addition to histologic grade and other factors, e.g., myometrial invasion in endometrial carcinoma or lesion volume in cervical carcinoma, lymph node metastases are a significant prognostic factor [2][3][4][5]. Staging follows the International Federation of Gynecology and Obstetrics (FIGO) classification [6] and the TNM system [7].…”

Section: Introductionmentioning

confidence: 99%

USPIO-enhanced MRI for preoperative staging of gynecological pelvic tumors: preliminary results

Keller

Michel

Fröhlich³

et al. 2004

European Radiology

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The aim of this study was to assess nodal enhancement with ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) during preoperative staging of gynecological pelvic tumors within the same imaging session for the primary tumor. Pelvic MRI was performed 18-28 h after intravenous infusion of USPIO (Combidex/Sinerem, 2.6 mg Fe/kg body weight) in 13 women (mean age 51 years) scheduled for surgery for biopsy proven ( n=11) or clinically suspected ( n=2) uterine carcinoma. Axial T1-weighted spin-echo (SE), T2-weighted fast SE (FSE; with fat saturation), fast spoiled gradient-recalled (FSPGR) echo, sagittal and oblique T2-weighted FSE sequences were acquired on a 1.5-T system. Lymph nodes were prospectively staged using standard criteria, i.e., size and shape, as well as USPIO enhancement. Results were correlated with histology findings. MRI correctly staged all primary uterine tumors. In one case, the preoperative diagnosis of stage IV switched the therapeutic approach to radiochemotherapy. Ninety-one (86 benign, 5 malignant) of the histologically characterized nodes could be correlated with their MRI counterparts. One node was false positive; three micrometastases greater than 5 mm and one 5-mm metastasis were missed. On a nodal basis, the sensitivity score was 0.33 and the specificity score, 0.99. On a patient basis, the sensitivity score was 0.25 and the specificity score, 0.80. Our preliminary results indicate that USPIO-enhanced pelvic MRI for preoperative nodal assessment is feasible within one imaging session for primary tumors and that it has a high specificity. However, the low sensitivity in the present study is a limitation for the clinical application of this technique.

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Section: Introductionmentioning

confidence: 99%

USPIO-enhanced MRI for preoperative staging of gynecological pelvic tumors: preliminary results

Keller

Michel

Fröhlich³

et al. 2004

European Radiology

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“…Elliott et al (14) reported that the incidence of positive nodes in patients with stage IA1 disease was 0.8%. A few publications have reported that the overall incidence of lymph node metastases in patients with depth of invasion of 3-5 mm was 7.1%, although it varied from 0% to 13.8% (15)(16)(17)(18)(19)(20) . In this study, the incidence of lymph node metastasis in stage IA1 cervical cancer was slightly higher than in previous studies (13,14) , especially in the depth of invasion of 1-3 mm group.…”

Section: Discussionmentioning

confidence: 99%

Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

Lee

Park

et al. 2006

Int J Gynecol Cancer

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The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1-3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.

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“…There were 14 cases with positive nodes (6%) and 13 of these died of recurrent disease (1.9%). Buckley et al [26] found higher mortality rates in 94 women with Stage 1A2 squamous cell carcinoma treated by radical hysterectomy and pelvic lymphadenopathy. Of note is the fact only 52 (55%) had conisation prior to definitive surgery and it is not stated how the others were diagnosed preoperatively.…”

Section: Stage 1a2 Diseasementioning

confidence: 99%

Treatment and follow-up of women with microinvasive cervical cancer

Cairns

Cruickshank

2006

Reviews in Gynaecological and Perinatal Practice

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Lymph Node Metastases and Prognosis in Patients With Stage IA sub 2 Cervical Cancer

Cited by 21 publications

References 0 publications

USPIO-enhanced MRI for preoperative staging of gynecological pelvic tumors: preliminary results

USPIO-enhanced MRI for preoperative staging of gynecological pelvic tumors: preliminary results

Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

Treatment and follow-up of women with microinvasive cervical cancer

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