Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study

Gabriella Ferrandina, Luigi Pedone Anchora, Valerio Gallotta, Anna Fagotti, Enrico Vizza, Vito Chiantera, Pierandrea De Iaco, Alfredo Ercoli, Giacomo Corrado, Carolina Bottoni, Francesco Fanfani, Giovanni Scambia

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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.

Original languageEnglish
Pages (from-to)2311-2318
Number of pages8
JournalAnnals of Surgical Oncology
Volume24
Issue number8
DOIs
Publication statusPublished - Aug 2017

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Uterine Cervical Neoplasms
Retrospective Studies
Lymph Nodes
Neoplasm Metastasis
Lymph Node Excision
Logistic Models
Sentinel Lymph Node Biopsy
Lymph
Chi-Square Distribution
Patient Selection
Regression Analysis
Guidelines

Keywords

  • Journal Article

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Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study. / Ferrandina, Gabriella; Pedone Anchora, Luigi; Gallotta, Valerio; Fagotti, Anna; Vizza, Enrico; Chiantera, Vito; De Iaco, Pierandrea; Ercoli, Alfredo; Corrado, Giacomo; Bottoni, Carolina; Fanfani, Francesco; Scambia, Giovanni.

In: Annals of Surgical Oncology, Vol. 24, No. 8, 08.2017, p. 2311-2318.

Research output: Contribution to journalArticle

Ferrandina, G, Pedone Anchora, L, Gallotta, V, Fagotti, A, Vizza, E, Chiantera, V, De Iaco, P, Ercoli, A, Corrado, G, Bottoni, C, Fanfani, F & Scambia, G 2017, 'Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study', Annals of Surgical Oncology, vol. 24, no. 8, pp. 2311-2318. https://doi.org/10.1245/s10434-017-5917-0
Ferrandina, Gabriella ; Pedone Anchora, Luigi ; Gallotta, Valerio ; Fagotti, Anna ; Vizza, Enrico ; Chiantera, Vito ; De Iaco, Pierandrea ; Ercoli, Alfredo ; Corrado, Giacomo ; Bottoni, Carolina ; Fanfani, Francesco ; Scambia, Giovanni. / Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study. In: Annals of Surgical Oncology. 2017 ; Vol. 24, No. 8. pp. 2311-2318.
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AU - Ferrandina, Gabriella

AU - Pedone Anchora, Luigi

AU - Gallotta, Valerio

AU - Fagotti, Anna

AU - Vizza, Enrico

AU - Chiantera, Vito

AU - De Iaco, Pierandrea

AU - Ercoli, Alfredo

AU - Corrado, Giacomo

AU - Bottoni, Carolina

AU - Fanfani, Francesco

AU - Scambia, Giovanni

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N2 - 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.

AB - 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.

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