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

Abstract

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.

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

“…9,10,12,28-33 The incidence of lymph node metastasis in microinvasive cervical cancer is low. In a study by Lee et al, 33 1 (1.5%) of 115 patients with a depth of invasion of less than 1 mm had lymph node metastasis. Two (4.2%) of 59 patients with 1-to 3-mm invasion and 1 (3.7%) of 28 patients with 3-to 5-mm invasion had lymph node metastasis.…”

“…Of the 4 patients with lymph node metastasis, 2 patients had LVSI. 33 According to the literature, based on surgical treatment, the incidence of pelvic lymph node metastasis in stage Ib, stage IIa, and stage IIb cervical cancer is approximately 12%-22%, 10%-27%, and 34%-43%, respectively (Table 2). It should be taken into account that the incidence of histologically defi ned lymph node metastasis may be lower than the true number, because routine histological examination is usually done on a very limited number of sections.…”

A case of bilateral pelvic lymph node involvement in stage 1a1 squamous cell carcinoma of cervix and a review of the literature

“…The patient received chemoradiation and remained disease-free 15 months after the initiation of treatment. In 2006, Lee et al 13 described two more cases with lymph node metastasis, one of which had positive LVSI. This patient underwent radical hysterectomy and PLND and remained disease-free 54 months after surgery.…”

Impact du staging ganglionnaire cœlioscopique sur la stratégie thérapeutique dans les cancers du col utérin

“…d'indication à ré aliser une lymphadé nectomie. En effet, le risque de mé tastase ganglionnaire dans ce cas est estimé à 1 % [20]. En pré sence d'emboles vasculaires sur la piè ce opé ratoire, une lymphadé nectomie pelvienne doit ê tre ré alisé e, car le risque de mé tastase ganglionnaire devient plus significatif [25].…”

“…En pré sence d'emboles vasculaires sur la piè ce opé ratoire, une lymphadé nectomie pelvienne doit ê tre ré alisé e, car le risque de mé tastase ganglionnaire devient plus significatif [25]. L'incidence de l'envahissement ganglionnaire pelvien est de 5 % au stade IA2, de 15 % au stade IB1, de 20 % au stade IB2, de 30 % au stade IIA et de 40 % au stade IIB [3,11,14,20,23]. Le risque d'envahissement ganglionnaire lomboaortique est de moins de 4 % au stade IB1.…”