Nicolai, L. (Laure) (2021) Lymph node assessment in cervical carcinoma with ≤5 mm depth of invasion and >7 mm diameter: Recommended in case of LVSI and a diameter of >3 mm. thesis, Medicine.
Full text available on request.Abstract
Objectives In the 2018 FIGO staging system, cervical cancers with ≤5 mm depth of invasion (DOI) and a diameter of >7 mm, first classified as FIGO stage IB, are now classified as stage IA. In this population, it is unclear what the risk of lymph node metastases (LNM) is, and consequently, what treatment is recommended. This study aims to determine the incidence of LNM and to study the association between disease-related characteristics and LNM. Methods All women diagnosed with FIGO (2009) IB cervical cancer between 1985 and 2020, with a tumor with ≤5 mm DOI and a diameter of >7 mm were selected from patient records of the Amsterdam University Medical Center and the University Medical Center Groningen. Cases with LNM were revised by an expert pathologist. The incidence of LNM and associations between disease-related characteristics and LNM were calculated. HRs were estimated for allcause and disease-related mortality and recurrence of disease. Results Of 391 patients included, 10 had pathologically confirmed LNM (2.6%, 95% CI: 1.2%- 4.7%). In case of lymphovascular space invasion (LVSI), both univariate and multivariate analysis showed an increased risk of LNM (p=.003 and p=.012, respectively). No LNM was found in cases without LVSI and a DOI of ≤3 mm. The overall survival rate was 96.2% (95% CI: 93.8%-97.8%). Conclusions We recommend a pelvic lymph node assessment in all patients with cervical cancer with a DOI of ≤5 mm and a diameter of >7 mm, except in the absence of LVSI and a DOI of ≤3 mm.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Yigit, dr. R. and Mom, dr. C.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:32 |
| Last Modified: | 07 Jan 2022 08:32 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2978 |
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