scholarly journals Lymph-Vascular Space Invasion in Patients with Stages IA2-IIA2 Cervical Cancer Treated with Laparoscopic versus Open Radical Hysterectomy

2021 ◽  
Vol Volume 13 ◽  
pp. 1179-1186
Author(s):  
Wancheng Zhao ◽  
Qing Yang
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Vascular Space ◽  
Vascular Space Invasion

Surgical Treatment of Microinvasive Cervical Cancer: Analysis of Pathologic Features With Implications on Radicality

2015 ◽  
Vol 25 (4) ◽  
pp. 694-698 ◽  
Author(s):  
Juliana Yoko Yoneda ◽  
Joana Froes Braganca ◽  
Luis Otavio Sarian ◽  
Patrícia Patury Borba ◽  
Jose Carlos J. Conceição ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Residual Disease ◽  
Pelvic Lymphadenectomy ◽  
Cancer Stage ◽  
Positive Margins ◽  
Vascular Space ◽  
Pathologic Features ◽  
Cold Knife ◽  
Vascular Space Invasion

ObjectivesTo evaluate pathologic features with implications on surgical radicality in women treated with radical hysterectomy and pelvic lymphadenectomy for cervical cancer stage IA1 with lymph vascular space invasion (LVSI) and stage IA2 by correlating findings in conization and hysterectomy specimens.MethodsWomen with cervical cancer stage IA1 with LVSI and stage IA2 diagnosed by loop electrosurgical excisional procedure or cold knife conization were treated with radical hysterectomy and pelvic lymphadenectomy from January 1999 to December 2011 in 2 institutions.ResultsFifty patients were enrolled: 40 with stage IA2 and 10 with stage IA1 with LVSI. Median age was 43 (30–67) years. All patients underwent cervical conization for diagnosis (45 loop electrosurgical excisional procedure, 5 cold knife). Lymph vascular space invasion was detected in 15 patients (30%). Two patients had positive pelvic nodes. No parametrial involvement was detected in the entire cohort. Positive margins were present in 35 patients, and residual disease was detected in 22 patients (44%). Positive margins predicted residual disease at radical hysterectomy (P = 0.02). Medium follow-up time was 51 months. One patient developed a pelvic recurrence, and there were no disease-related deaths.ConclusionsPatients with positive margins in cone biopsy specimens have an increased risk of residual disease at radical hysterectomy and require careful evaluation before conservative surgery. Pelvic lymph node evaluation is essential because lymph node metastasis may occur even in early stages. The lack of parametrial invasion in this study reinforces the knowledge that the select group of patients with microinvasive cervical carcinoma stages IA1 LVSI and stage IA2 have a very low risk of parametrial infiltration. Less radical surgery can be carefully considered for these patients.

Preoperative lymph-vascular space invasion is associated with nodal metastases in women with early-stage cervical cancer

2007 ◽  
Vol 106 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Michael R. Milam ◽  
Michael Frumovitz ◽  
Ricardo dos Reis ◽  
Russell R. Broaddus ◽  
Roland L. Bassett ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Nodal Metastases ◽  
Vascular Space ◽  
Early Stage Cervical Cancer ◽  
Vascular Space Invasion

Cervical biopsy and excision procedure specimens lack sufficient predictive value for lymph-vascular space invasion seen at hysterectomy for cervical cancer

2008 ◽  
Vol 199 (2) ◽  
pp. 151.e1-151.e4 ◽  
Author(s):  
Michael A. Bidus ◽  
Angela S. Caffrey ◽  
Whitney B. You ◽  
Charles A. Amezcua ◽  
Mildred R. Chernofsky ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Cervical Biopsy ◽  
Vascular Space ◽  
Vascular Space Invasion

Incidence of Lymph Node Metastases in Women With Low-Risk Early Cervical Cancer (<2 cm) Without Lymph-Vascular Invasion

2018 ◽  
Vol 28 (4) ◽  
pp. 788-793 ◽  
Author(s):  
Lucas Minig ◽  
Anna Fagotti ◽  
Giovanni Scambia ◽  
Gloria Salvo ◽  
María Guadalupe Patrono ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Lymph Node Involvement ◽  
Pelvic Lymphadenectomy ◽  
Low Risk ◽  
Node Metastasis ◽  
Vascular Space ◽  
Vascular Space Invasion

ObjectiveTo determine the incidence of lymph node metastasis in women with low-risk cervical cancer stage IA2 or IB1 (<2 cm) without lymph-vascular space invasion.MethodsA multicenter retrospective study was performed in patients who underwent radical or simple hysterectomy, conization, or trachelectomy plus pelvic lymphadenectomy for cervical cancer between January 2000 and June 2016.ResultsA total of 271 patients were included in the study. Median age and body mass index were 46 years (range, 23–77 years) and 24 kg/m2 (range, 18–48 kg/m2), respectively. Twenty-two patients had stage IA2 (8.1%), and 249 (91.9%) had stage IB1. The median tumor size was 14 mm (range, 5–20 mm). Tumor grades were 1 (n = 63 [23.2%]), 2 (n = 120 [44.3%]), 3 (n = 63 [23.2%]), and unknown (25 [9.2%]). Median depth stromal invasion was 6 mm (range, 3–20 mm). Histologic subtypes included squamous (n = 171 [63.1%]), adenocarcinoma (n = 92 [33.9%]), and adenosquamous (n = 8 [3.0%]). Overall incidence of lymph node metastasis was 2.9% (n = 8). The incidence of lymph node involvement in G1, G2, and G3 was 0% (0/63), 5% (6/120), and 3.1% (2/63), respectively. No patient with stage IA2 (regardless of grade or histology) or G1 cervical cancer less than 2 cm (stage IB1) had lymph node metastasis.ConclusionsPatients with stage IA2 or IB1 (G1) with tumor size of less than 2 cm and no lymph-vascular space invasion may not need lymph node evaluation. On the other hand, 95% and 98% of patients with grade 2 or 3 tumors, respectively, could potentially undergo an unnecessary lymphadenectomy. Further studies with bigger sample size are required to confirm these results.

Histopathologic prognostic factors in stage IIb cervical carcinoma treated with radical hysterectomy and pelvic-node dissection — an analysis with mathematical statistics

1993 ◽  
Vol 3 (4) ◽  
pp. 219-225 ◽  
Author(s):  
T. Kamura ◽  
N. Tsukamoto ◽  
N. Tsuruchi ◽  
T. Kaku ◽  
T. Saito ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Radical Hysterectomy ◽  
Tumor Diameter ◽  
Node Dissection ◽  
Pelvic Node ◽  
Parametrial Invasion ◽  
Vascular Space ◽  
Pelvic Node Dissection ◽  
Vascular Space Invasion

Of 107 patients with stage IIb cervical cancer who underwent laparotomy, 82 (77%) could be treated with radical hysterectomy (RAH) and pelvic-node dissection (PND). The remaining 25 patients were unsuitable for radical surgery because of para-aortic lymph node metastases, direct cancer invasion into the bladder muscle, and/or fixed enlarged pelvic lymph nodes (PLN): Such patients were treated with radiation therapy after laparotomy. Fifty-nine of RAH patients were given postoperative pelvic radiation because they had PLN metastases, parametrial invasion, and/or full thickness cervical stromal invasion. The overall 5-year survival of the patients undergoing RAH was significantly better than that of those who could not be treated with RAH (P< 0.001). In the RAH patients, parametrial invasion, which clinically defines stage IIb, was found only in 45%. Univariate analysis of histopathologic prognostic factors revealed that PLN metastasis, parametrial invasion, adenocarcinoma, and lymph-vascular space invasion significantly affected survival of the RAH patients (P< 0.05). Multivariate analysis using Cox's proportional hazards regression model, however, selected only PLN metastasis as a strong prognostic factor (P< 0.001). Concerning PLN metastasis patients with two or more positive nodal groups vs. 49%,P< 0.0001). The logistic regression analysis revealed that tumor diameter, parametrial invasion and lymph-vascular space invasion were independently correlated with PLN metastases in two or more nodal groups. The present data suggest that (i) the patients with massive pelvic extension of cancer cannot be cured by radiation therapy alone, (ii) the strong determinant of the prognosis of the patients undergoing RAH and PND is PLN metastasis. Therefore, for these patients with poor prognosic factors, other treatment modalities should be considered. From the present study it seems that planning RAH and PND for patients with stage IIb disease might make it possible to select poor prognostic subgroups, who have extra cervical extension or PLN metastases in two or more groups, and be useful in individualizing treatment.

Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

2006 ◽  
Vol 16 (3) ◽  
pp. 1184-1187 ◽  
Author(s):  
K. B.M. Lee ◽  
J. M. Lee ◽  
C. Y. Park ◽  
K. B. Lee ◽  
H. Y. Cho ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Uterine Cervix ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Vascular Space ◽  
Vascular Space Invasion

The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1–3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.

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