New procedures for the identification of sentinel lymph node: shaping the horizon of future management in early stage uterine cervical cancer

Rossetti, Diego; Vitale, Salvatore Giovanni; Tropea, Alessandro; Biondi, Antonio; Laganà, Antonio Simone

doi:10.1007/s13304-017-0456-6

Cited by 43 publications

(22 citation statements)

References 64 publications

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“…Fortunately, sentinel lymph node (SLN) biopsy, a method of intraoperative assessment, is increasingly being used in the standard management of early-stage cervical cancer. A series of studies have confirmed the high sensitivity and negative predictive value of SLN biopsy 33 , 34 . As a result, the National Comprehensive Cancer Network (NCCN) guidelines also recommend performing SLN biopsy as an alternative option for LN staging in the early stages of cervical cancer 35 .…”

Section: Discussionmentioning

confidence: 89%

Comparison of different lymph node staging systems in patients with node-positive cervical squamous cell carcinoma following radical surgery

Guo¹,

Zhu²,

Wu³

et al. 2020

J. Cancer

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Objective: We compared the prognostic accuracy of four lymph node (LN) staging systems - the 2018 International Federation of Gynecology and Obstetrics (FIGO) stage, number of positive lymph node (PLN), metastatic lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) systems - in patients with node-positive cervical squamous cell carcinoma (CSCC) following radical surgery and explored the optimal choice for clinical applications. Materials and methods: Data were retrospectively collected from 928 node-positive CSCC patients who underwent radical surgery between 2006 and 2014 in our center. Tree-based recursive partitioning was applied to split variables (PLN, LNR, and LODDS) into low-risk and high-risk groups. The log-rank test was used to compare survival curves, and Cox regression analysis was performed to identify prognostic factors. The relative discriminative abilities of the different staging systems were assessed using Harrell's concordance index (C index) and the Akaike information criterion (AIC). Results: The mean number of PLNs was 3.8 (range: 1-44 nodes). According to the 2018 FIGO staging system, 831 patients had stage IIIC1, and 97 had stage IIIC2. For the PLN system, 761 patients were included in the low-risk group, and 167 were included in the high-risk group. For the LNR system, 658 patients were included in the low-risk group, and 270 were included in the high-risk group. The low-risk LODDS group included 694 patients, while the high-risk LODDS group included 234 patients. All four staging systems had a significant influence on patients' progression-free survival (PFS, P < 0.001) and overall survival (OS, P < 0.001). Univariate analysis and multivariate Cox analysis adjusted for significant factors indicated that the four staging systems were significant prognostic factors for PFS and OS. Among them, the PLN system was noted to have the best prognostic performance for both PFS (C index: 0.582; AIC: 8213.33) and OS (C index: 0.624; AIC: 8433.80). Conclusion: The PLN system seemed to be the most accurate LN staging method for predicting node-positive CSCC following radical surgery.

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Section: Discussionmentioning

confidence: 89%

Comparison of different lymph node staging systems in patients with node-positive cervical squamous cell carcinoma following radical surgery

Guo¹,

Zhu²,

Wu³

et al. 2020

J. Cancer

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“…The treatment for cervical cancer principally involves surgery, radiation, and chemotherapy. New surgical techniques, such as laparoscopic radical hysterectomy and sentinel lymph node biopsy, have also become available [ 10 , 11 ]. On the other hand, a basic therapeutic strategy for FDCS is prioritized to guarantee complete surgical tumor resection because of the low response rate to established chemotherapy and radiotherapy [ 3 – 6 ].…”

Section: Discussionmentioning

confidence: 99%

Follicular dendritic cell sarcoma of the uterine cervix: a case report

et al. 2020

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Background: Follicular dendritic cell sarcoma (FDCS) is a rare mesenchymal tumor that mostly occurs in systemic lymph nodes. FDCS in the uterine cervix has not yet been reported. Case presentation: A 49-year-old woman was referred to our department with a cervical tumor, which was histologically suspected to be undifferentiated carcinoma. She underwent hysterectomy, salpingo-oophorectomy, and pelvic lymphadenectomy after neoadjuvant chemotherapy with paclitaxel and carboplatin. The resected specimen contained high numbers of spindle cells and was immunohistochemically confirmed to be FDCS. The tumor was completely resected and recurrence was not detected at a 16-month follow-up. Conclusion: FDCS is an extremely rare malignant tumor in the uterine cervix, and an accurate diagnosis and complete resection are essential for a good prognosis.

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“…Valenti et al 6 showed that some markers, such as p16, E-cadherin, Ki67, pRb and p53, were able to predict which cervical intraepithelial lesions had a greater chance of developing. Rossetti et al 7 suggested sentinel lymph nodes (SLNs) for the detection of early-stage cervical cancer. By studying cervical cancer biological markers can not only reveal early cervical lesions but also predict the recurrent and residual conditions of patients after cervical lesion removal, preventing fertility loss at a young age and reducing the economic and psychological burden caused by unnecessary surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

<p>Evaluation of PCR-Reverse Dot Blot Human Papillomavirus Genotyping Test in Predicting Residual/Recurrent CIN 2+ in Posttreatment Patients in China</p>

Zhang¹,

Dong²,

Chen³

et al. 2020

CMAR

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To assess the clinical value of the PCR-reverse dot blot human papillomavirus genotyping test during follow-up of patients with CIN grade 2 or worse (CIN 2+). Methods: Four hundred patients with CIN 2+ receiving treatment from January 2008 to January 2017 were included in our study. Postoperative follow-up procedures comprised HPV examination and cervical cytology every 3-6 months for the first 2 years and then followed up every 6-12 months. A pathology examination was performed when there was a positive funding for HPV 16/18 or an abnormal ThinPrep cytology test (TCT) with or without positive for HR-HPV according to the American Society for Coloscopy and Cervical Pathology (ASCCP) guidelines. Results: The median follow-up period was 27.10±12.47 months (ranging from 3 to 50 months). During follow-up, 12.00% (48/400) of the women developed residual/recurrent disease. The highest risk in CIN 2+ and CIN 3+ residual/recurrence was HPV-16/-18 (hazard ratio (HR)=12.898, 95% CI= 6.849-24.289; HR= 20.726, 95% CI= 9.64-44.562, respectively). Among the different follow-up methods, type-specific (TP) HR-HPV persistent infection showed the highest cumulative incidence risk (CIR) (84.62%, 95% CI=73.29-95.94) and HR (5.38, 95% CI= 2.596-11.149) during the 4-year follow-up period. At the CIN 2+ and CIN 3+ endpoints, TP-HPV testing had relatively high sensitivity (84.62%, 95% CI=73.29-95.94 and 89.28%, 95% CI= 77.83-100.00, respectively) and specificity (78.07%, 95% CI= 72.70-83.44 and 75.73%, 95% CI= 70.30-81.17, respectively). However, at the CIN 2+/CIN 3+ endpoint, TCT follow-up had a sensitivity of 60.42%/62.16% (95% CI=46.58-72.25/46.54-77.79) and specificity of 90.18%/88.72% (95% CI=86.95-93.41/85.35-92.10). Conclusion: TP HR-HPV follow-up can provide a reliable and sensitive clinical reference for CIN 2+ postoperative patients.

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New procedures for the identification of sentinel lymph node: shaping the horizon of future management in early stage uterine cervical cancer

Cited by 43 publications

References 64 publications

Comparison of different lymph node staging systems in patients with node-positive cervical squamous cell carcinoma following radical surgery

Comparison of different lymph node staging systems in patients with node-positive cervical squamous cell carcinoma following radical surgery

Follicular dendritic cell sarcoma of the uterine cervix: a case report

<p>Evaluation of PCR-Reverse Dot Blot Human Papillomavirus Genotyping Test in Predicting Residual/Recurrent CIN 2+ in Posttreatment Patients in China</p>

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