Gabriella Ferrandina1,2, Luigi Pedone Anchora3, Valerio Gallotta4, Anna Fagotti4,3, Enrico Vizza5, Vito Chiantera6, Pierandrea De Iaco7, Alfredo Ercoli8, Giacomo Corrado5, Carolina Bottoni4, Francesco Fanfani9, Giovanni Scambia4,3. 1. Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli", Rome, Italy. gabriella.ferrandina@gmail.com. 2. Institute of Obstetrics/Gynecology, Catholic University of Sacred Heart, Rome, Italy. gabriella.ferrandina@gmail.com. 3. Institute of Obstetrics/Gynecology, Catholic University of Sacred Heart, Rome, Italy. 4. Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli", Rome, Italy. 5. Gynecologic Oncology Unit, Department of Oncological Surgery, "Regina Elena" National Cancer Institute, Rome, Italy. 6. Division of Gynecologic Oncology, Fondazione "Giovanni Paolo II", Campobasso, Italy. 7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, S. Orsola Hospital, University of Bologna, Bologna, Italy. 8. Department of Obstetrics and Gynecology, University of Eastern Piedmond, Novara, Italy. 9. Department of Medicine and Aging Sciences, University "G. D'Annunzio", Chieti, Pescara, Italy.
Abstract
BACKGROUND: Sentinel lymph node (SLN) biopsy has emerged as one of the most appreciated techniques for reducing the rate of complete lymph node dissection (LND) performed in patients with early-stage cervical cancer (ECC). However, its performances are still a matter of debate and, to improve them, international guidelines recommend performing at least unilateral LND in case of SLN mapping. In a prior study, we identified a group of patients without evidence of lymph node metastasis (LNM). Our objective is to define a precise risk of LNM for each ECC patient in order to significantly tailor surgery for ECC. METHODS: Clinical and pathological data of ECC patients were retrospectively collected by eight Italian institutions. Chi-square test or Fisher's exact test along with logistic regression analysis was used to determine the association of each variable between patients with or without LNM. Results of logistic regression have been used as a basis to calculate the probability to harboring LNM. RESULTS: A total of 463 ECC patients were identified. No LNM was detected among the 161 (34.8%) patients who met the criteria and were defined as Very Low Risk. In the other 302 patients, the precise risk of LNM was calculated, and it was <1% in 31 (10.3%) patients. CONCLUSIONS: Defining the precise risk of LNM could lead to proper selection of patients in whom any lymph nodal procedure, including SLN, could be avoided.
BACKGROUND: Sentinel lymph node (SLN) biopsy has emerged as one of the most appreciated techniques for reducing the rate of complete lymph node dissection (LND) performed in patients with early-stage cervical cancer (ECC). However, its performances are still a matter of debate and, to improve them, international guidelines recommend performing at least unilateral LND in case of SLN mapping. In a prior study, we identified a group of patients without evidence of lymph node metastasis (LNM). Our objective is to define a precise risk of LNM for each ECC patient in order to significantly tailor surgery for ECC. METHODS: Clinical and pathological data of ECC patients were retrospectively collected by eight Italian institutions. Chi-square test or Fisher's exact test along with logistic regression analysis was used to determine the association of each variable between patients with or without LNM. Results of logistic regression have been used as a basis to calculate the probability to harboring LNM. RESULTS: A total of 463 ECC patients were identified. No LNM was detected among the 161 (34.8%) patients who met the criteria and were defined as Very Low Risk. In the other 302 patients, the precise risk of LNM was calculated, and it was <1% in 31 (10.3%) patients. CONCLUSIONS: Defining the precise risk of LNM could lead to proper selection of patients in whom any lymph nodal procedure, including SLN, could be avoided.
Authors: Kristyna Nemejcova; Roman Kocian; Christhardt Kohler; Jiri Jarkovsky; Jaroslav Klat; Alberto Berjon; Radovan Pilka; Borek Sehnal; Blanca Gil-Ibanez; Ezequiel Lupo; Almerinda Petiz; Octavio Arencibia Sanchez; Peter Kascak; Fabio Martinelli; Alessandro Buda; Jiri Presl; Marc Barahona; Luc van Lonkhuijzen; Wiktor Szatkowski; Lubos Minar; Maja Pakiz; Pavel Havelka; Cristina Zorrero; Marcin Misiek; Leon Cornelius Snyman; Dariusz Wydra; Ignace Vergote; Alla Vinnytska; Mikulas Redecha; Martin Michal; Solveig Tingulstad; Barbara Kipp; Grzegorz Szewczyk; Robert Toth; Francisco Javier de Santiago Garcia; Pluvio Jesus Coronado Martin; Robert Poka; Karl Tamussino; Mathieu Luyckx; Maxime Fastrez; Juan Carlos Staringer; Anna Germanova; Andrea Plaikner; Sylva Bajsova; Pavel Dundr; Nina Mallmann-Gottschalk; David Cibula Journal: Cancers (Basel) Date: 2020-04-29 Impact factor: 6.639
Authors: Luigi Pedone Anchora; Vittoria Carbone; Valerio Gallotta; Francesco Fanfani; Francesco Cosentino; Luigi Carlo Turco; Camilla Fedele; Nicolò Bizzarri; Giovanni Scambia; Gabriella Ferrandina Journal: Cancers (Basel) Date: 2020-06-12 Impact factor: 6.639