Limits...
Distribution pattern of lymph node metastases and its implication in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with stage IA to IIA cervical cancer.

Li X, Yin Y, Sheng X, Han X, Sun L, Lu C, Wang X - Radiat Oncol (2015)

Bottom Line: Pelvic lymph node metastases were found in 168 of 665 patients resulting in a metastasis rate of 25.3%.Tumor size and lymph node metastases of the common iliac were significantly related to lymph node metastases of the para-aortic (p = 0.045, < 0.001, respectively).Selective regional irradiation including the correlated lymphatic drainage regions should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China. xinglan_li0225@163.com.

ABSTRACT

Background: To study the distribution pattern of lymph node metastases of stage IA to IIA cervical cancer and to clarify the individualized clinical target volume delineation of regional lymph nodes (CTVn).

Methods: A total of 665 cases with International Federation Gynecology and Obstetrics stage IA to IIA cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. The clinicopathological factors related to lymph node metastases were analyzed using logistic regression analysis.

Results: Pelvic lymph node metastases were found in 168 of 665 patients resulting in a metastasis rate of 25.3%. Binary logistic regression analysis showed that age, lymph vascular space involvement, and deep stromal invasion statistically influenced pelvic lymph node metastases (p = 0.017, < 0.001, < 0.001, respectively). Pathological morphology type, lymph node metastases of the obturator, the external iliac and internal iliac, and the para-aortic had a strong influence on lymph node metastases of the common iliac (p = 0.022, 0.003, < 0.001, 0.009, respectively). Tumor size and lymph node metastases of the common iliac were significantly related to lymph node metastases of the para-aortic (p = 0.045, < 0.001, respectively). Lymph node metastases of the obturator, the external iliac and internal iliac were strongly correlated to lymph node metastases of the circumflex iliac node distal to the external iliac node (CINDEIN; p = 0.027, 0.024, respectively).

Conclusions: Factors related to lymph node metastases should be comprehensively considered to design and tailor CTVn for radiotherapy of cervical cancer. Selective regional irradiation including the correlated lymphatic drainage regions should be performed.

No MeSH data available.


Related in: MedlinePlus

Distribution of positive PLN in stage 1 A to 11 A cervical cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4340863&req=5

Fig1: Distribution of positive PLN in stage 1 A to 11 A cervical cancer.

Mentions: The median number of dissected lymph nodes was 19, with a range of 14–54. Pelvic lymph node metastases were found in 168 patients with a metastasis rate of 25.3%. The most common site for pelvic lymph node metastases was the obturator (17.6%; 117 of 665 patients), followed by the external iliac and internal iliac nodes (13.4%; 89 of 665 patients), common iliac nodes (3.6%; 24 of 665 patients), CINDEIN (2.6%; 17 of 665 patients), and parametrial nodes (1.8%; 12 of 665 patients). Metastases to the para-aortic (1.7%; 11 of 665 patients) and sacral nodes (0.6%; 4 of 665 patients) were relatively rare. The rates of lymph node metastasis in different groups of cervical cancer are shown in Figure 1.Figure 1


Distribution pattern of lymph node metastases and its implication in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with stage IA to IIA cervical cancer.

Li X, Yin Y, Sheng X, Han X, Sun L, Lu C, Wang X - Radiat Oncol (2015)

Distribution of positive PLN in stage 1 A to 11 A cervical cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4340863&req=5

Fig1: Distribution of positive PLN in stage 1 A to 11 A cervical cancer.
Mentions: The median number of dissected lymph nodes was 19, with a range of 14–54. Pelvic lymph node metastases were found in 168 patients with a metastasis rate of 25.3%. The most common site for pelvic lymph node metastases was the obturator (17.6%; 117 of 665 patients), followed by the external iliac and internal iliac nodes (13.4%; 89 of 665 patients), common iliac nodes (3.6%; 24 of 665 patients), CINDEIN (2.6%; 17 of 665 patients), and parametrial nodes (1.8%; 12 of 665 patients). Metastases to the para-aortic (1.7%; 11 of 665 patients) and sacral nodes (0.6%; 4 of 665 patients) were relatively rare. The rates of lymph node metastasis in different groups of cervical cancer are shown in Figure 1.Figure 1

Bottom Line: Pelvic lymph node metastases were found in 168 of 665 patients resulting in a metastasis rate of 25.3%.Tumor size and lymph node metastases of the common iliac were significantly related to lymph node metastases of the para-aortic (p = 0.045, < 0.001, respectively).Selective regional irradiation including the correlated lymphatic drainage regions should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China. xinglan_li0225@163.com.

ABSTRACT

Background: To study the distribution pattern of lymph node metastases of stage IA to IIA cervical cancer and to clarify the individualized clinical target volume delineation of regional lymph nodes (CTVn).

Methods: A total of 665 cases with International Federation Gynecology and Obstetrics stage IA to IIA cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. The clinicopathological factors related to lymph node metastases were analyzed using logistic regression analysis.

Results: Pelvic lymph node metastases were found in 168 of 665 patients resulting in a metastasis rate of 25.3%. Binary logistic regression analysis showed that age, lymph vascular space involvement, and deep stromal invasion statistically influenced pelvic lymph node metastases (p = 0.017, < 0.001, < 0.001, respectively). Pathological morphology type, lymph node metastases of the obturator, the external iliac and internal iliac, and the para-aortic had a strong influence on lymph node metastases of the common iliac (p = 0.022, 0.003, < 0.001, 0.009, respectively). Tumor size and lymph node metastases of the common iliac were significantly related to lymph node metastases of the para-aortic (p = 0.045, < 0.001, respectively). Lymph node metastases of the obturator, the external iliac and internal iliac were strongly correlated to lymph node metastases of the circumflex iliac node distal to the external iliac node (CINDEIN; p = 0.027, 0.024, respectively).

Conclusions: Factors related to lymph node metastases should be comprehensively considered to design and tailor CTVn for radiotherapy of cervical cancer. Selective regional irradiation including the correlated lymphatic drainage regions should be performed.

No MeSH data available.


Related in: MedlinePlus