Topographic distribution of lymph node metastasis in patients with stage IB1 cervical cancer: an analysis of 8314 lymph nodes.
Topographic distribution of lymph node metastasis in patients with stage IB1 cervical cancer: an analysis of 8314 lymph nodes.
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DOI：
10.1186/s13014-021-01781-x
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发表时间：
2021-03-20
期刊：
影响因子：
--
通讯作者：
Jiang P
中科院分区：
文献类型：
--
作者：
Cai J;He X;Wang H;Dong W;Zhang Y;Zhao J;Willborn KC;Huang B;Wang Z;Jiang P
对于IB1期宫颈癌患者，建议行系统盆腔淋巴清扫或全盆腔放疗。然而，宫颈癌中淋巴肿瘤扩散的确切模式尚不清楚。在目前的研究中，我们评估了IB1期宫颈癌的淋巴结转移分布，以探索定制癌症治疗的可能性。根据FIGO 2009年的资料，对289例IB1期宫颈癌患者进行了回顾性分析。自2014年10月至2017年12月，所有患者均接受了腹腔镜下广泛子宫切除术(Querleu和Morrow C2型)和系统性盆腔淋巴清扫加或不加腹主动脉旁淋巴清扫术(根据Querleu和Morrow标准为2级或3级)。从7个明确的解剖位置切除的淋巴结以及其他组织进行了组织病理学检查，并根据WHO/IARC的分类进行了分型、分级和分期。共分析8314个淋巴结，平均每个患者有31.88个 ± ，10.34个(平均 ± SD)。44例(15.22%)有淋巴结转移。淋巴扩散至不同解剖部位的发生率为0%(骶前)至30.92%(闭孔结节)。肿瘤大小大于2 cm、组织学证实的淋巴血管侵犯和宫旁侵犯与淋巴转移的风险显著相关，而肥胖(体重指数 ≥ 25)独立地与淋巴转移呈负相关。IB1期宫颈癌患者的淋巴转移发生率较低，但与预后相关。对于那些肿瘤较小、肥胖且无宫旁侵犯或LVSI的低危患者，可考虑个体化治疗。
Systematic pelvic lymphadenectomy or whole pelvic irradiation is recommended for the patients with stage IB1 cervical cancer. However, the precise pattern of lymphatic tumor spread in cervical cancer is unknown. In the present study we evaluated the distribution of nodal metastases in stage IB1 cervical cancer to explore the possibilities for tailoring cancer treatment. A total of 289 patients with cervical cancer of stage IB1, according to FIGO 2009, were retrospectively analyzed. All patients underwent laparoscopic radical hysterectomy (Querleu and Morrow type C2) and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy (level 2 or level 3 according to Querleu and Morrow) from October 2014 to December 2017. Lymph nodes removed from 7 well-defined anatomical locations as well as other tissues were examined histopathologically, and typed, graded, and staged according to the WHO/IARC classification. Totally 8314 lymph nodes were analyzed with the average number of 31.88 ± 10.34 (Mean ± SD) lymph nodes per patient. Nodal metastases were present in 44 patients (15.22%). The incidence of lymphatic spread to different anatomic sites ranged from 0% (presacral) to 30.92% (obturator nodes). Tumor size above 2 cm, histologically proven lymphovascular space involvement (LVSI) and parametrial invasion were shown to be significantly correlated with the higher risk of lymphatic metastasis, while obesity (BMI ≥ 25) was independently negatively associated with lymphatic metastases. The incidence of lymph node metastasis in patients with stage IB1 cervical cancer is low but prognostically relevant. Individual treatment could be considered for the selected low-risk patients who have smaller tumors and obesity and lack of the parametrial invasion or LVSI.
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影响因子：
4.7
作者：
Le Borgne, Gwenael;Mercier, Mariette;Joly, Florence
通讯作者：
Joly, Florence
DOI：
10.1111/j.1447-0756.2007.00526.x
发表时间：
2007-06-01
影响因子：
1.6
作者：
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作者：
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影响因子：
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作者：
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