Frequency of Pelvic Lymph Node Metastases and Parametrial Involvement in Stage IA2 Cervical Cancer A Population-Based Study and Literature Review
Frequency of Pelvic Lymph Node Metastases and Parametrial Involvement in Stage IA2 Cervical Cancer A Population-Based Study and Literature Review
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DOI：
10.1111/igc.0b013e318197f3ef
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发表时间：
2009-01-01
影响因子：
4.8
通讯作者：
van der Velden, Jacobus
中科院分区：
文献类型：
--
作者：
van Meurs, Hannah;Visser, Otto;van der Velden, Jacobus
背景：IA 2期宫颈癌淋巴结转移的频率据报道为0%至9.7%。治疗建议也各不相同，从锥形活检到Wertheim根治性子宫切除术和盆腔淋巴结清扫术。本研究的目的是深入了解IA 2期宫颈癌淋巴结转移和/或宫旁受累的真实频率。方法：回顾了1994年至2006年登记的48例IA 2期宫颈癌患者的医院记录，并进行了文献检索。结果：在48例登记患者中，14例被确认患有IA 2期。未发现淋巴结转移或宫旁浸润及复发，文献资料显示淋巴结转移的风险为4.8%（范围0%-9.7%）。腺癌的存在和淋巴管间隙的侵犯的情况下，导致淋巴结转移的风险较低（分别为0.3%和1.3%）。结论：选择的IA 2期宫颈癌患者发生油淋巴结转移的风险较低。对于IA 2期鳞状细胞癌伴淋巴管间隙侵犯的患者，应推荐标准盆腔淋巴结清扫术。如果淋巴结阳性，应包括子宫旁切除术。在其他患者中，治疗需要个体化，不必包括淋巴结清扫或子宫旁切除术。
Background: The frequency of lymph node metastases in stage IA2 cervical cancer is reported to range from 0% to 9.7%. Treatment recommendations vary likewise from a cone biopsy to a Wertheim radical hysterectomy and pelvic lymph node dissection. The objective of this study was to gel insight into the true frequency of lymph node metastages and/or parametrial involvement in stage IA2 cervical cancer.Methods: The hospital records of 48 patients with stage IA2 cervical carcinoma who registered from 1994 to 2006 were reviewed, and a literature search was performed.Results: Of 48 registered patients, 14 were confirmed to have stage IA2. No lymph node metastases or parametrial invasion and recurrences were found. The collated literature data showed a risk of lymph node metastases of 4.8% (range, 0%-9.7%). The presence of adenocarcinoma and the absence of lymph vascular space invasion resulted in a low risk on lymph node metastases (0.3% and 1.3%, respectively). Parametrial involvement has not been reported.Conclusions: The risk of he selected patients with stage IA2 cervical cancer oil lymph node metastases is low. In patients with stage IA2 squamous cell cancer with lymph vascular space invasion, a standard pelvic lymph node dissection should be recommended. Parametrectomy should be included if the nodes are positive. In the other patients, the treatment call be individualized and does not have to include lymph node dissection or parametrectomy.