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Microscopic Evaluation of Lymph-Node-Bearing Tissue in Early-Stage Cervical Cancer: A Dual-Institution Review

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

We compared two different methods of microscopic lymph node examination of cervical cancer radical hysterectomy specimens to ascertain which method translates into higher nodal counts and improved detection of nodal metastasis, at M. D. Anderson Cancer Center (MDACC) and the University of North Carolina (UNC).

Methods

We retrospectively reviewed the records of 155 patients with early-stage cervical cancer who underwent open radical hysterectomy and pelvic lymph node dissection from 2000 to 2006. At MDACC lymph nodes were grossly dissected from submitted adipose tissue surgical specimens and then microscopically examined. At UNC, grossly detected lymph nodes and the remaining adipose tissue were microscopically examined. Data regarding clinicopathologic features and lymph node dissection were available for all patients.

Results

No differences in stage, grade or histology were noted between the two centers. The median age and body mass index were both higher at MDACC (40 versus 36 years of age; 28 versus 26 mg/m2; P < 0.05) The median lymph node count was lower at MDACC (16 versus 23; P = 0.001). By multivariate analysis, UNC evaluation was associated with higher total lymph node count (P = 0.001). However, no significant difference was noted between institutions in proportion of patients with nodal metastases (MDACC 20.3%; UNC 13.5%; P = 0.47).

Conclusion

The UNC method of microscopically examining the entire adipose tissue sample may be associated with higher nodal count at open radical hysterectomy. Higher nodal count, however, may not translate into increased identification of nodal metastases.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Louisville Medical Center, Louisville, KY, USA

    Michael R. Milam MD, MPH

  2. Division of Gynecologic Oncology, University of North Carolina Medical Center at Chapel Hill, Chapel Hill, NC, USA

    Lisa Abaid MD, MPH & Paola A. Gehrig MD

  3. Hospital de Clinicas de Porto Alegre, Gynecologic Oncology Service, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Ricardo dos Reis MD

  4. Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Michael Frumovitz MD, MPH & Pedro T. Ramirez MD

  5. Division of Gynecologic Pathology, University of North Carolina Medical Center at Chapel Hill, Chapel Hill, NC, USA

    Chad Livasy MD

  6. Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Russell R. Broaddus MD, PhD

Authors
  1. Michael R. Milam MD, MPH
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  2. Lisa Abaid MD, MPH
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  3. Ricardo dos Reis MD
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  4. Michael Frumovitz MD, MPH
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  5. Paola A. Gehrig MD
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  6. Chad Livasy MD
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  7. Russell R. Broaddus MD, PhD
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  8. Pedro T. Ramirez MD
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Corresponding author

Correspondence to Michael R. Milam MD, MPH.

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Milam, M.R., Abaid, L., Reis, R.d. et al. Microscopic Evaluation of Lymph-Node-Bearing Tissue in Early-Stage Cervical Cancer: A Dual-Institution Review. Ann Surg Oncol 17, 1106–1110 (2010). https://doi.org/10.1245/s10434-009-0870-1

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  • DOI: https://doi.org/10.1245/s10434-009-0870-1

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