Publication details

Pelvic lymphadenectomy improves survival in patients with cervical cancer with low-volume disease in the sentinel node: A retrospective multicenter cohort study

Authors

ZAAL Afra ZWEEMER Ronald P. ZIKÁN Michal DUŠEK Ladislav QUERLEU Denid LÉCURU Fabrice BATS Anne Sophie JACH Robert SEVCIK Libor GRAF Petar KLAT Jaroslav DYDUCH Grzegorz MENSDORFF-POULLY Silvia von KENTER Gemma G. VERHEIJEN René H.M. CIBULA David

Year of publication 2014
Type Article in Periodical
Magazine / Source INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1097/IGC.0000000000000043
Field Oncology and hematology
Keywords Isolated tumor cells; Low-volume disease; Lymph node dissection; Lymph node metastasis; Micrometastasis; Sentinel lymph node; Survival; Uterine cervical cancer
Description Objective: In this study, we aimed to describe the value of pelvic lymph node dissection (LND) after sentinel lymph node (SN) biopsy in early-stage cervical cancer. Methods: We performed a retrospective multicenter cohort study in 8 gynecological oncology departments. In total, 645 women with International Federation of Gynecology and Obstetrics stage IA to IIB cervical cancer of squamous, adeno, or adenosquamous histologic type who underwent SN biopsy followed by pelvic LND were enrolled in this study. Radioisotope tracers and blue dyewere used to localize the sentinel node, and pathologic ultrastaging was performed. Results: Among the patients with low-volume disease (micrometastases and isolated tumor cells) in the sentinel node, the overall survivalwas significantly better (P = 0.046) ifmore than 16 non-SNs were removed. No such significant difference in survivalwas detected in patients with negative or macrometastatic sentinel nodes. Conclusions: Our findings indicate that in patients with negative or macrometastatic disease in the sentinel nodes, an additional LND did not alter survival. Conversely, our data suggest that the survival of patients with low-volume disease is improved when more than 16 additional lymph nodes are removed. If in a prospective trial our data are confirmed, we would suggest a 2-stage operation.

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