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Article

Micrometastases in Sentinel Lymph Nodes Represent a Significant Negative Prognostic Factor in Early-Stage Cervical Cancer: A Single-Institutional Retrospective Cohort Study

1
Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, 128 00 Prague, Czech Republic
2
Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, 128 00 Prague, Czech Republic
3
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
4
Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
5
Department of Pathology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, 128 00 Prague, Czech Republic
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(6), 1438; https://doi.org/10.3390/cancers12061438
Received: 15 April 2020 / Revised: 23 May 2020 / Accepted: 28 May 2020 / Published: 31 May 2020
(This article belongs to the Special Issue Therapies in Cervical Cancer)
The data on the prognostic significance of low volume metastases in lymph nodes (LN) are inconsistent. The aim of this study was to retrospectively analyze the outcome of a large group of patients treated with sentinel lymph node (SLN) biopsy at a single referral center. Patients with cervical cancer, stage T1a-T2b, common tumor types, negative LN on preoperative staging, treated by primary surgery between 01/2007 and 12/2016, with at least unilateral SLN detection were included. Patients with abandoned radical surgery due to intraoperative SLN positivity detected by frozen section were excluded. All SLNs were postoperatively processed by an intensive protocol for pathological ultrastaging. Altogether, 226 patients were analyzed. Positive LN were detected in 38 (17%) cases; macrometastases (MAC), micrometastases (MIC), isolated tumor cells (ITC) in 14, 16, and 8 patients. With the median follow-up of 65 months, 22 recurrences occurred. Disease-free survival (DFS) reached 90% in the whole group, 93% in LN-negative cases, 89% in cases with MAC, 69% with MIC, and 87% with ITC. The presence of MIC in SLN was associated with significantly decreased DFS and OS. Patients with MIC and MAC should be managed similarly, and SLN ultrastaging should become an integral part of the management of patients with early-stage cervical cancer. View Full-Text
Keywords: micrometastasis; isolated tumor cells; sentinel lymph node; cervical cancer; pathological ultrastaging; prognostic parameters; risk of recurrence micrometastasis; isolated tumor cells; sentinel lymph node; cervical cancer; pathological ultrastaging; prognostic parameters; risk of recurrence
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MDPI and ACS Style

Kocian, R.; Slama, J.; Fischerova, D.; Germanova, A.; Burgetova, A.; Dusek, L.; Dundr, P.; Nemejcova, K.; Jarkovsky, J.; Sebestova, S.; Fruhauf, F.; Dostalek, L.; Ballaschova, T.; Cibula, D. Micrometastases in Sentinel Lymph Nodes Represent a Significant Negative Prognostic Factor in Early-Stage Cervical Cancer: A Single-Institutional Retrospective Cohort Study. Cancers 2020, 12, 1438. https://doi.org/10.3390/cancers12061438

AMA Style

Kocian R, Slama J, Fischerova D, Germanova A, Burgetova A, Dusek L, Dundr P, Nemejcova K, Jarkovsky J, Sebestova S, Fruhauf F, Dostalek L, Ballaschova T, Cibula D. Micrometastases in Sentinel Lymph Nodes Represent a Significant Negative Prognostic Factor in Early-Stage Cervical Cancer: A Single-Institutional Retrospective Cohort Study. Cancers. 2020; 12(6):1438. https://doi.org/10.3390/cancers12061438

Chicago/Turabian Style

Kocian, Roman, Jiri Slama, Daniela Fischerova, Anna Germanova, Andrea Burgetova, Ladislav Dusek, Pavel Dundr, Kristyna Nemejcova, Jiri Jarkovsky, Silvie Sebestova, Filip Fruhauf, Lukas Dostalek, Tereza Ballaschova, and David Cibula. 2020. "Micrometastases in Sentinel Lymph Nodes Represent a Significant Negative Prognostic Factor in Early-Stage Cervical Cancer: A Single-Institutional Retrospective Cohort Study" Cancers 12, no. 6: 1438. https://doi.org/10.3390/cancers12061438

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