Hans H B Wenzel1, Kim G G Van Kol2, Hans W Nijman3, Valery E P P Lemmens4, Maaike A Van der Aa5, Renée M F Ebisch2, Ruud L M Bekkers6. 1. Department of Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands; Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: h.h.b.wenzel@rug.nl. 2. Department of Obstetrics and Gynaecology, Catherina Cancer Institute, Catharina Hospital, Eindhoven, the Netherlands. 3. Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. 4. Department of Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands; Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, the Netherlands. 5. Department of Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands. 6. Department of Obstetrics and Gynaecology, Catherina Cancer Institute, Catharina Hospital, Eindhoven, the Netherlands; Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
Abstract
OBJECTIVE: Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread is classified FIGO IA instead of FIGO IB in the revised staging system, as horizontal spread is no longer considered. We aimed to determine the incidence of lymph node metastasis (LNM) and, consequently, the necessity of pelvic lymph node assessment. METHODS: Patients diagnosed between January 2015 and May 2019 with cervical cancer FIGO (2009) stage IB with ≤5 mm depth of invasion and >7 mm horizontal spread, were identified from the Netherlands Cancer Registry. Associations between disease-characteristics and lymph node metastasis (LNM), and overall survival, were assessed. RESULTS: Of 170 patients, six (3.5%) had LNM: 4/53 (7.6%) with adenocarcinoma and 2/117 (1.7%) with squamous cell carcinoma (p = .077). Four-year overall survival was 98.2%. LNM was observed more often in tumours with LVSI (4/43 patients, 9.3%) than without LVSI (2/117 patients, 1.7%) (p = .045). In adenocarcinoma with 3-5 mm depth of invasion LNM rate was 10% (4/40). None of the following tumours were observed with LNM: squamous cell carcinoma without LVSI (0/74); adenocarcinoma with <3 mm depth of invasion (0/13); <3 mm depth of invasion without LVSI (0/36). CONCLUSIONS: Lymph node assessment is essential in any tumour with LVSI or in adenocarcinoma with 3-5 mm depth of invasion. It can be omitted in squamous cell carcinoma without LVSI, in adenocarcinoma with <3 mm depth of invasion and in any tumours without LVSI and with <3 mm depth of invasion.
OBJECTIVE: Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread is classified FIGO IA instead of FIGO IB in the revised staging system, as horizontal spread is no longer considered. We aimed to determine the incidence of lymph node metastasis (LNM) and, consequently, the necessity of pelvic lymph node assessment. METHODS:Patients diagnosed between January 2015 and May 2019 with cervical cancer FIGO (2009) stage IB with ≤5 mm depth of invasion and >7 mm horizontal spread, were identified from the Netherlands Cancer Registry. Associations between disease-characteristics and lymph node metastasis (LNM), and overall survival, were assessed. RESULTS: Of 170 patients, six (3.5%) had LNM: 4/53 (7.6%) with adenocarcinoma and 2/117 (1.7%) with squamous cell carcinoma (p = .077). Four-year overall survival was 98.2%. LNM was observed more often in tumours with LVSI (4/43 patients, 9.3%) than without LVSI (2/117 patients, 1.7%) (p = .045). In adenocarcinoma with 3-5 mm depth of invasion LNM rate was 10% (4/40). None of the following tumours were observed with LNM: squamous cell carcinoma without LVSI (0/74); adenocarcinoma with <3 mm depth of invasion (0/13); <3 mm depth of invasion without LVSI (0/36). CONCLUSIONS: Lymph node assessment is essential in any tumour with LVSI or in adenocarcinoma with 3-5 mm depth of invasion. It can be omitted in squamous cell carcinoma without LVSI, in adenocarcinoma with <3 mm depth of invasion and in any tumours without LVSI and with <3 mm depth of invasion.
Authors: Eva Meixner; Line Hoeltgen; Philipp Hoegen; Laila König; Nathalie Arians; Laura L Michel; Katharina Smetanay; Carlo Fremd; Andreas Schneeweiss; Jürgen Debus; Juliane Hörner-Rieber Journal: Technol Cancer Res Treat Date: 2022 Jan-Dec
Authors: Mieke L G Ten Eikelder; Floor Hinten; Anke Smits; Maaike A Van der Aa; Ruud L M Bekkers; Joanna IntHout; Hans H B Wenzel; Petra L M Zusterzeel Journal: Cancers (Basel) Date: 2022-06-27 Impact factor: 6.575