In:
International Journal of Gynecologic Cancer, BMJ, Vol. 28, No. 4 ( 2018-05), p. 788-793
Abstract:
To determine the incidence of lymph node metastasis in women with low-risk cervical cancer stage IA2 or IB1 ( 〈 2 cm) without lymph-vascular space invasion. Methods A multicenter retrospective study was performed in patients who underwent radical or simple hysterectomy, conization, or trachelectomy plus pelvic lymphadenectomy for cervical cancer between January 2000 and June 2016. Results A total of 271 patients were included in the study. Median age and body mass index were 46 years (range, 23–77 years) and 24 kg/m 2 (range, 18–48 kg/m 2 ), respectively. Twenty-two patients had stage IA2 (8.1%), and 249 (91.9%) had stage IB1. The median tumor size was 14 mm (range, 5–20 mm). Tumor grades were 1 (n = 63 [23.2%]), 2 (n = 120 [44.3%] ), 3 (n = 63 [23.2%]), and unknown (25 [9.2%] ). Median depth stromal invasion was 6 mm (range, 3–20 mm). Histologic subtypes included squamous (n = 171 [63.1%]), adenocarcinoma (n = 92 [33.9%] ), and adenosquamous (n = 8 [3.0%]). Overall incidence of lymph node metastasis was 2.9% (n = 8). The incidence of lymph node involvement in G1, G2, and G3 was 0% (0/63), 5% (6/120), and 3.1% (2/63), respectively. No patient with stage IA2 (regardless of grade or histology) or G1 cervical cancer less than 2 cm (stage IB1) had lymph node metastasis. Conclusions Patients with stage IA2 or IB1 (G1) with tumor size of less than 2 cm and no lymph-vascular space invasion may not need lymph node evaluation. On the other hand, 95% and 98% of patients with grade 2 or 3 tumors, respectively, could potentially undergo an unnecessary lymphadenectomy. Further studies with bigger sample size are required to confirm these results.
Type of Medium:
Online Resource
ISSN:
1048-891X
,
1525-1438
DOI:
10.1097/IGC.0000000000001236
Language:
English
Publisher:
BMJ
Publication Date:
2018
detail.hit.zdb_id:
2009072-9
Bookmarklink