A survey of lymph node involvement under preoperative medical imaging in cervical cancer patients
1Department of Human Anatomy, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, 610065 Chengdu, Sichuan, China
2Biotherapy Laboratory of Gynecological Oncology, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, West China Second Hospital, Sichuan University, 610065 Chengdu, Sichuan, China
3Department of Histology and Embryology, Kunming medical university Haiyuan college, 650106 Kunming, Yunnan, China
4Department of Radiology, West China Second University Hospital, Sichuan University, 610065 Chengdu, Sichuan, China
5Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610065 Chengdu, Sichuan, China
DOI: 10.31083/j.ejgo4301011 Vol.43,Issue 1,February 2022 pp.36-41
Submitted: 16 September 2021 Accepted: 26 October 2021
Published: 15 February 2022
*Corresponding Author(s): Lingjun Liu E-mail: firstname.lastname@example.org
*Corresponding Author(s): Hongying Zhou E-mail: email@example.com
† These authors contributed equally.
Objective: To investigate the characteristics and distribution patterns of clinically metastatic nodes assessed by Computed Tomography (CT) in preoperative cervical cancer patients; to address the importance of obturator and/or inguinal lymph nodes as sentinel lymph nodes. Methods: A total of 217 patients with cervical carcinoma treated by lymph node dissection (LND) between 2009 and 2014 were included. All preoperative CT/MRI (Magnetic Resonance Imaging) imaging data of these patients were reviewed. The relationship of patient characteristics age, tumor stages, and corresponding lymph node metastasis status were analyzed. We put emphasis on the distribution pattern of positive lymph nodes from pre-operative imaging and compared the different frequencies of each regional and non-regional lymph node group respectively. The data of the 5-year survival rate from follow-up was taken into consideration too. SPSS 24.0 (IBM Corp., Chicago, IL, USA) was used for statistical analysis. Results: The overall lymph node metastasis (LNM) rate was 92.6% in 217 cases. When regional nodes were involved, obturator groups were concerned in 154 (76.6%). The inguinal group was involved in 146 (72.6%) in the area of non-regional lymph node. The 5-year survival rates of return visits were 92.6% and 82.1% in stage IB and IIA, respectively. Age distribution was not associated with the International Federation of Gynecology and Obstetrics (FIGO) stage as well as the incidence and patterns of nodal metastasis. Conclusions: obturator and inguinal groups play a decisive role in the metastases process of cervical cancer, and can be regarded as a candidate for sentinel lymph nodes.
Cervical cancer; Lymph node metastasis; Sentinel lymph node
Hang Xiong,Tao Yi,Junmei Hu,Hongyan Zeng,Lingjun Liu,Hongying Zhou. A survey of lymph node involvement under preoperative medical imaging in cervical cancer patients. European Journal of Gynaecological Oncology. 2022. 43(1);36-41.
 Henriksen E. The lymphatic spread of carcinoma of the cervix and of the body of the uterus. American Journal of Obstetrics and Gynecology. 1949; 58: 924–942.
 Lin A, Ma S, Dehdashti F, Markovina S, Schwarz J, Siegel B, et al. Detection of distant metastatic disease by positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) at initial staging of cervical carcinoma. International Journal of Gynecologic Cancer. 2019; 29: 487–491.
 Badib AO, Kurohara SS, Webster JH, Pickren JW. Metastasis to organs in carcinoma of the uterine cervix: Influence of treatment on incidence and distribution. Cancer. 1968; 21: 434–439.
 McMahon CJ, Rofsky NM, Pedrosa I. Lymphatic Metastases from Pelvic Tumors: Anatomic Classification, Characterization, and Staging. Radiology. 2010; 254: 31–46.
 Cabanas RM. Anatomy and biopsy of sentinel lymph nodes. Urologic Clinics of North America. 1992; 19: 267–276.
 Levenback C, Coleman RL, Burke TW, Bodurka-Bevers D, Wolf JK, Gershenson DM. Intraoperative Lymphatic Mapping and Sentinel Node Identification with Blue Dye in Patients with Vulvar Cancer. Gynecologic Oncology. 2001; 83: 276–281.
 Benedetti-Panici P, Maneschi F, Scambia G, Greggi S, Cutillo G, D’Andrea G, et al. Lymphatic Spread of Cervical Cancer: an Anatomical and Pathological Study Based on 225 Radical Hysterectomies with Systematic Pelvic and Aortic Lymphadenectomy. Gynecologic Oncology. 1996; 62: 19–24.
 Dostalek L, Åvall-Lundqvist E, Creutzberg CL, Kurdiani D, Ponce J, Dostalkova I, et al. ESGO Survey on Current Practice in the Management of Cervical Cancer. International Journal of Gynecological Cancer. 2018; 28: 1226–1231.
 Salvo G, Ramirez PT, Levenback CF, Munsell MF, Euscher ED, Soliman PT, et al. Sensitivity and negative predictive value for sentinel lymph node biopsy in women with early-stage cervical cancer. Gynecologic Oncology. 2017; 145: 96–101.
 Koh W, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2018; 16: 170–199.
 Liptak JM, Boston SE. Nonselective Lymph Node Dissection and Sentinel Lymph Node Mapping and Biopsy. Veterinary Clinics of North America: Small Animal Practice. 2019; 49: 793–807.
 Diab Y. Sentinel Lymph Nodes Mapping in Cervical Cancer a Comprehensive Review. International Journal of Gynecologic Cancer. 2017; 27: 154–158.
 Bodurtha Smith AJ, Fader AN, Tanner EJ. Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2017; 216: 459–476.e10.
 Tanaka T, Sasaki S, Tsuchihashi H, Terai Y, Yamamoto K, Yamada T, et al. Which is better for predicting pelvic lymph node metastases in patients with cervical cancer. Medicine. 2018; 97: e0410.
 Bader AA, Winter R, Haas J, Tamussino KF. Where to look for the sentinel lymph node in cervical cancer. American Journal of Obstetrics and Gynecology. 2007; 197: 678.e1–678.e7.
 Dostalek L, Runnebaum I, Raspagliesi F, Vergote I, Dusek L, Jarkovsky J, et al. Oncologic outcome after completing or abandoning (radical) hysterectomy in patients with cervical cancer and intraoperative detection of lymph node positivity; ABRAX (ABandoning RAd hyst in cerviX cancer). International Journal of Gynecologic Cancer. 2020; 30: 261–264.
 Sakuragi N, Satoh C, Takeda N, Hareyama H, Takeda M, Yamamoto R, et al. Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy. Cancer. 1999; 85: 1547–1554.
 Ouldamer L, Marret H, Acker O, Barillot I, Body G. Unusual localizations of sentinel lymph nodes in early stage cervical cancer: a review. Surgical Oncology. 2012; 21: e153–e157.
 MICHEL G. Lymphatic spread in stage Ib and II cervical carcinoma: Anatomy and surgical implications. Obstetrics & Gynecology. 1998; 91: 360–363.
 Kasuya G, Toita T, Furutani K, Kodaira T, Ohno T, Kaneyasu Y, et al. Distribution patterns of metastatic pelvic lymph nodes assessed by CT/MRI in patients with uterine cervical cancer. Radiation Oncology. 2013; 8: 139.
 Henriksen E. The Dispersion of Cancer of the Cervix. Radiology. 1950; 54: 812–815.
 Plentl AA, Friedman EA. Lymphatic system of the female genitalia. The morphologic basis of oncologic diagnosis and therapy. Major Problems in Obstetrics and Gynecology. 1971; 2: 1–223.
 Cibula D, McCluggage WG. Sentinel lymph node (SLN) concept in cervical cancer: Current limitations and unanswered questions. Gynecologic Oncology. 2019; 152: 202–207.
 Paño B, Sebastià C, Ripoll E, Paredes P, Salvador R, Buñesch L, et al. Pathways of Lymphatic Spread in Gynecologic Malignancies. RadioGraphics. 2015; 35: 916–945.
 Takeda N, Sakuragi N, Takeda M, Okamoto K, Kuwabara M, Negishi H, et al. Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstetricia et Gynecologica Scandinavica. 2002; 81: 1144–1151.
 Du R, Li L, Ma S, Tan X, Zhong S, Wu M. Lymph nodes metastasis in cervical cancer: Incidences, risk factors, consequences and imaging evaluations. Asia-Pacific Journal of Clinical Oncology. 2018; 14: e380–e385.
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