Pelvic lymphnodectomy following radiation in cervical carcinoma

Morton, Daniel G.; Lagasse, Leo D.; Moore, James R.; Jacobs, Melville L.; Amromin, George D.

doi:10.1016/0002-9378(64)90739-2

Cited by 34 publications

(5 citation statements)

References 19 publications

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“…Though there was not much difference in fibronectin positivity among the tumors with volume from 5000 to 15,000 cumm, yet a significant difference can be observed among tumors with tumor volume <5000 cumm and more than 15,000 cumm. As lymph node metastasis was also considered as a significant prognostic factor in cases of carcinoma of cervix by several investigators, [11,12] this was correlated with fibronectin positivity. Observations in the study showed that the fibronectin positivity in the tumors carries more weightage as a prognostic indicator rather than the absence of fibronectin.…”

Section: Discussionmentioning

confidence: 96%

“…Tumor volume on fresh specimens was estimated according to Dargent et al [10] According to several investigators, lymph node involvement was considered to be one of the prognostic factors in cervical carcinoma. [11,12] Hence, a correlation was made between lymph node metastasis and tumor volume, to see if any importance can be given to tumor volume as an independent prognostic factor in cases of carcinoma cervix. The observations of our study indicate that the tumor shows lymph node metastasis as the tumor volume increases.…”

Section: Discussionmentioning

confidence: 99%

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Estimation of tumor volume and its prognostic significance to study the biological behavior of carcinoma of cervix

Dawson

Garg

Choudhary

2016

Asian Journal of Oncology

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Objective: The objective of this study was to assess a correlation between tumor volume, the spread and metastatic potential of the tumor. Materials and Methods: A prospective study was done on 40 cases of carcinoma of cervix with stage IIb or less. The hysterectomy specimens alongwith the lymph nodes were sent to the histopathology department. Clinical details were taken from gynecology department. Hematoxylin and eosin slides were prepared and seen. Tumor volume was calculated by using the formula TV = π/6×Length×Width×Depth. Immunohistochemistry for Fibronectin and LN5 was also done. Results: The median age of the patients in this group was 47.5 years, with a range of 30–80 years. The major histological type of carcinoma among 40 cases is squamous cell carcinoma (SCC) (in 90% of cases), and 10% had adenocarcinoma. Pathological staging of the carcinoma cervix showed stage Ib, IIa, IIb, and IVa (35%, 20%, 40%, and 5%). Tumor volume estimated on pathological specimens of 40 cases ranged from 230 cumm to 49,760 cumm with a mean of 14,844 cumm. 12 (30%) cases had tumor volume more than 15,000 cumm, 12 (30%) cases had tumor volume <5000 cumm and 16 (40%) cases had tumor volume between 5000 and 15,000 cumm. 17% of the tumors with tumor volume <5000 cumm showed lymph node metastases, whereas 67% (out of 12cases) of cases with tumor volume more than 15,000 cumm showed lymph node metastases. 67% of the tumors with tumor volume <5000 cumm showed 0/4 organs involvement, whereas all cases with tumor volume more than 15,000 cumm showed more than one organ involvement among vagina, uterus, parametrium or bladder/rectum. Fibronectin positivity was seen in 22 out of 44 cases (55%). Macrophages were seen surrounding the group of tumor cells by LN5 immunostaining. Conclusion: Tumor volume can be considered as an independent prognostic factor to assess the spread of the tumor. Cases with tumor volume <5000 cumm show low risk in terms of parametrial involvement and lymph node metastasis and those with tumor volume more than 15,000 cumm showed more organ spread. Fibronectin positivity carries some importance in low-risk cases. For macrophages, further detailed study needs to be carried out.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Estimation of tumor volume and its prognostic significance to study the biological behavior of carcinoma of cervix

Dawson

Garg

Choudhary

2016

Asian Journal of Oncology

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“…For example, the reported incidence of metastatic lymph nodes in lesions less than 1 cm ranges from 0%14 to 14%.33 Still other larger Stage I lesions have a reported range of lymph node metastasis of 6% to 37%. 30 Thus, collected statistics about pelvic lymphatics in early disease can be misleading and unreliable, and it is difficult to ascribe significance to them.…”

Section: Lymphaticsmentioning

confidence: 99%

Prognostic factors in cervical carcinoma: Implications in staging and management

Rotman

John

Boyce

1981

Cancer

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Individualization of treatment using judicious combinations of external and intracavitary irradiation remains the cornerstone of the radiation management of carcinoma of the cervix. The inherent propensity of this cancer to either confine itself to the pelvis or else spread in a systematic and predictable manner through lymphatic channels has facilitated its therapeutic control. The treatment of most early invasive cervical carcinomas is equally advantageous using either intracavitary radium or surgery. However, certain Stage I patients have morphologic and histologic characteristics that militate against tumor control. Factors such as tumor size, depth of invasion, vascular infiltration, uterine extension, and barrel-shaped presentation affect the course of the disease and survival. A clinical-pathologic staging for cervical carcinoma incorporating the above mentioned factors into the current clinical FIGO staging system has been suggested. It aims to facilitate the recognition of those early tumors that require additional external radiotherapy. A description of the role of surgery, intracavitary and external radiation, and their combinations is included. In advanced carcinoma of the cervix, failure can be attributed to either large tumors containing cores of hypoxic cells resistant to conventional radiation therapy or to uncontrolled subclinical disease in the lymphatics at or near the border of the irradiated area. Radiotherapy combined with surgery, oxygen enhancers, infusion chemotherapy, and large particle high LET radiation has been implemented to increase local control; for distal failures, extended field irradiation of paraaortic nodes has been found to be technically feasible and well tolerated and is being studied for its effects on increased survival. The rationale for newer treatment procedures, including preliminary results and their complications, is discussed.

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“…Thus, in stage I their occurrence has been assessed to range from about 18 to 21% (1,5). In more advanced stages the proportion of lymphatic node involvement increases to 27-47% (8,9,10). For the diagnosis of the spread through this route lymphography is often applied; however, its value is questioned because falsely negative results reach a substantial proportion of the total: e. g. in stage lb up to 19% (23).…”

Section: Introductionmentioning

confidence: 99%

57Co-Bleomycin Scintigraphy in Staging of Carcinoma of the Cervix

Pertyński¹,

Durski²

1985

Nuklearmedizin

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Summary65 patients with cervical cancer at various stages of the disease were studied scintigraphically after 57Co-bleomycin administration, active urine being flushed out from the bladder continuously. The patients were submitted to other auxiliary tests and the interpretation of scintigraphic images could thus be verified. Scintigraphic data were classified semiquantitatively by scoring in the range from zero to 5. Results were evaluated in terms of ROC-curves. This method of analysis permitted selection of cut-off levels for binary decisions that yielded satisfactory sensitivity and acceptable specificity of the test.

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Pelvic lymphnodectomy following radiation in cervical carcinoma

Cited by 34 publications

References 19 publications

Estimation of tumor volume and its prognostic significance to study the biological behavior of carcinoma of cervix

Estimation of tumor volume and its prognostic significance to study the biological behavior of carcinoma of cervix

Prognostic factors in cervical carcinoma: Implications in staging and management

57Co-Bleomycin Scintigraphy in Staging of Carcinoma of the Cervix

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