Article Data

  • Views 277
  • Dowloads 131

Original Research

Open Access

Nodal involvement evaluation in advanced cervical cancer: a single institutional experienc

  • C. Gonzalez-Benitez1
  • I. Zapardiel1,*,
  • P. I. Salas1
  • M. D. Diestro1
  • A. Hernandez1
  • J. De Santiago1

1Gynecologic Oncology Unit, La Paz University Hospital, Madrid (Spain)

DOI: 10.12892/ejgo340206 Vol.34,Issue 2,March 2013 pp.138-141

Published: 24 March 2013

*Corresponding Author(s): I. Zapardiel E-mail: ignaciozapardiel@hotmail.com

Abstract

Purpose: To assess the usefulness of different imaging techniques in the detection of nodal involvement in patients with advanced cervical carcinoma. Moreover, to analyze the correlation between the presurgical (FIGO) and postsurgical (pTNM) staging classifications. Materials and Methods: All patients diagnosed with advanced cervical cancer (FIGO Stages IIB-IV) from 2005 to 2012 were selected. The medical charts of 51 patients that underwent presurgical assessment with posterior surgical staging by means of paraaortic lymphadenectomy, were reviewed. Nodal status assessment by computed tomography scan (CT scan), magnetic resonance imaging (MRI), positron emission tomography (PET), and sonography was compared, as well as the size given in imaging techniques compared to the final pathologic report information. Results: Presurgical analysis by CT scan, MRI, PET, and sonography showed pelvic nodal involvement in 51.3% of patients, and para-aortic involvement in 30.8% of cases. CT scan showed positive pelvic nodes in 35% of cases, but pathologic confirmation was observed in just 17.6% of cases. However, MRI resulted in higher rates of up to 48.8% of cases. Concerning para-aortic nodal involvement, CT scan showed positive nodes in 25% of cases, MRI in 3.2% of cases, and the pathologic report in 15.6% of cases. The authors found significant differences between staging groups among both classifications (FIGO vs. pTNM; p < 0.001). Eight cases (15.7%) were understaged by FIGO classification. Conclusions: Despite all imaging techniques available, none has demonstrated to be efficient enough to avoid the systematic study of para-aortic nodal status by means of surgical evaluation.

Keywords

Cervical cancer; Staging; Imaging techniques; Lymphadenectomy; Nodal involvement; Extraperitoneal.

Cite and Share

C. Gonzalez-Benitez,I. Zapardiel,P. I. Salas,M. D. Diestro,A. Hernandez,J. De Santiago. Nodal involvement evaluation in advanced cervical cancer: a single institutional experienc. European Journal of Gynaecological Oncology. 2013. 34(2);138-141.

References

[1] Parkin D.M., Bray F., Ferlay J., Pisani P.: “Estimating the world cancer burden: Globocan 2000”. Int. J. Cancer, 2001, 94, 153.

[2] Holschneider C.H.: “Invasive cervical cancer: Epidemiology, clinical features, and diagnosis”. In: UpToDate, Basow D.S. (ed.), UpToDate, Waltham, MA, 2008.

[3] FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int. J. Gynecol. Obstet., 2009, 105, 103.

[4] Edge S.B., Byrd D.R., Compton C.C., Fritz A.C., Greene F.L., Trotti A. III: “AJCC Cancer Staging Manual: Cervix uteri cancer staging”. 7th Ed., New York, Springer, 2010.

[5] Lai C.H., Huang K.G., See L.C., Yen T.C., Tsai C.S., Chang T.C. et al.: “Restaging of recurrent cervical carcinoma with dual-phase 18F-fluoro-2-deoxy-D-glucose positron emission tomography”. Cancer, 2004, 100, 544.

[6] Gold M.A., Tian C., Whitney C.W., Rose P.G., Lanciano R.: “Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma”. Cancer, 2008, 112, 1954.

[7] Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. Diagnosis and treatment of cervical carcinomas, number 35, May 2002. Obstet. Gynecol., 2002, 99, 855.

[8] Oncoguía SEGO. Cancer de cuello uterino 2008. Available at http://www.sego.es/Content/pdf/CervixOncoguia2008.pdf

[9] Hertel H., Köhler C., Elhawary T., Michels W., Possover M., Schneider A.: “Laparoscopic staging compared with imaging techniques in the staging of advanced cervical cancer”. Gynecol. Oncol., 2002, 87, 46.

[10] Zanvettor P.H., Filho D.F., Neves A.R., Amorim M.J., Medeiros S.M., Laranjeiras L.C.: “Laparoscopic surgical staging of locally advanced cervix cancer (IB2 to IVA): initial experience”. Gynecol. Oncol., 2011, 120, 358.

[11] Stehman F.B., Bundy B.N., DiSaia P.J., Keys H.M., Larson J.E., Fowler W.C.: “Carcinoma of the cervix treated with radiation therapy: a multi-variate analysis of prognostic variables in the Gynecologic Oncology Group”. Cancer, 1991, 67, 2776.

[12] Gien L.T., Covens A.: “Lymph node assessment in cervical cancer: prognostic and therapeutic implications”. J. Surg. Oncol., 2009, 99, 242.

[13] Bipat S., Glas A.S., Van Der Velden J., Zwinderman A.H., Bossuyt P.M., Stoker J.: “Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review” (Review). Gynecol. Oncol., 2003, 91, 59.

[14] Yang W.T., Lam W.W., Yu M.Y., Cheung TH, Metreweli C.: “Comparison of dynamic helical CT and dynamic MR imaging in the evaluation of pelvic lymph nodes in cervical carcinoma”. Am. J. Roentgenol., 2000, 175, 759.

[15] Choi H.J., Roh J.W., Seo S.S., Lee S, Kim J.Y., Kim S.K. et al.: “Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: A prospective study”. Cancer, 2006, 106, 914.

[16] Sugawara Y., Eisbruch A., Kosud S., Recker B.E., Kison P.V., Wahl R.L.: “Evaluation of FDG-PET in patients with cervical cancer”. J. Nucl. Med., 1999, 40, 1125.

[17] Schawarz J.K., Siegel B.A., Dehdashti F., Grigsby P.W.: “Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma”. JAMA, 2007, 298, 2289.

[18] Perry W.: ‘Grigsby. The prognostic value of PET and PET/CT in cervical cancer”. Cancer Imag., 2008, 8, 146.

[19] Kizer N.T., Zighelboim I., Case A.S., Dewdney S.B., Thaker P.H., Massad L.S.: “The role of PET/CT in the management of patients with cervical cancer: Practice patterns of the members of the Society of Gynecologic Oncologists”. Gynecol. Oncol., 2009, 114, 310.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time

Conferences

Top