Saving the lymph nodes

We need improved imaging and staging techniques to identify metastatic disease in the lymph nodes. Once we are able to do this accurately, then we can save the lymph nodes. Until that time, however, gynecologic oncologists should give careful thought as to which nodes they choose to remove and how lymph node removal may affect short-term and long-term morbidity.

[1] Pardoll D.: "Cancer immunology". In: "Inflammation: Basic Principles and Clinical Correlates", Gallin J. I., Snyderman R., eds. Lippincott, William & Wilkins, Philadelphia， 1999.

[2] Munoz K. A., Harlan L., Trimble E. L.: "Patterns of care for women with ovarian cancer in the United States". J. Clin. Oncol., 1997, 15, 3408.

[3] Spirtos N. M., Gross G. M., Freddo J. L. et al.: "Cytoreductive surgery in advanced epithelial cancer of the ovary: the impact of aortic and pelvic lymphadenectomy". Gynecol. Oneal., 1995, 56, 345. .

[4] Creasman W. T., Morrow C. P., Bundy B. N. et al.: "Surgical pathologic spread patterns of endometrial cancer (a Gynecologic Oncology Group study)". Cancer, 1987, 60, 2035.

[5] Burke T. W., Levenback C., Tornos C. et al.: "Intra-abdominal lymphatic mapping to direct selective pelvic and para-aortic lymphadenectomy in women with high-risk endometrial cancer: results of a pilot study". Gynecol. Oncol., 1996, 62, 169.

[6] Trimble E. L., Kosary C.. Park P. C.: "Lymph node sampling and survival in endometrial cancer". Gynecol. Oncol., 1998, 71, 340.

[7] Morrow C., Bundy B., Kumar R. J. et al.: "Relationship between surgical-pathologic risk factors and outcome in clinical stages I and II carcinoma of the endometrium". Gynecol. Oneal., 1991, 40, 55.

[8] Potish R. A., Twiggs L. B., Adcock L. L. et al.: "Para-aortic lymph node radiotherapy in cancer of the uterine corpus". Obstet Gynecol., 1985, 654, 251.

[9] Seven B. U., Nadji M., Averette H. E. et al.: "Microinvasive carcinoma of the cervix". Cancer, 1992, 70, 2121.

[10] Delgado G., Bundy B. N., Fowler W. C. et al.: "A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group study". Gynecol. Oncol., 1989, 35, 314.

[11] Magrina J. F.: "Primary surgery for stage IB-IIA cervical cancer, including short-term and long-term morb心ty and treatment in pregnancy". Monogr. Natl. Cancer Inst., 1996, 21, 53.

[12] Russell A.H.: "Integration of diagnostic imaging in the clinical management of cervical cancer". Monogr. Natl. Cancer inst., 1996, 21, 35.

[13] Sedlis A.,H omesley H., Bundy B. N. et al.: "Positive groin lymph nodes in superficial squamous cell vulvar cancer". Am. J. Obstet. Gynecol., 1987, 156, 1159-64.

[14] DiSaia P. J., Creasman W. T., Rich W. M.: "An alternative approach to early cancer of the vulva".Am. J. Obstet. Gynecol.,1979, 133, 825.

[15] Stehman F., Bundy B., Thomas G. et al.: "Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy: a prospective study of the Gynecologic Oncology Group". Obstet. Gynecol., 1992, 74, 490.

[16] Petereit D., Mehta M., Buckler D. et al.: "A retrospective review of nodal treatment for vulvar cancer". Am. J. Clin. Oneal., 1993, 16, 38.