Microscopic Evaluation of Lymph-Node-Bearing Tissue in Early-Stage Cervical Cancer: A Dual-Institution Review
- 74 Downloads
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).
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.
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).
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.
- 2.Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol. 1999;73:177–83.CrossRefPubMedGoogle Scholar
- 5.Marchiole P, Buenerd A, Benchaib M, Nezhat K, Dargent D, Mathevet P. Clinical significance of lympho vascular space involvement and lymph node micrometastases in early-stage cervical cancer: a retrospective case-control surgico-pathological study. Gynecol Oncol. 2005;97:727–32.CrossRefPubMedGoogle Scholar
- 15.Boggess JF, Gehrig PA, Cantrell L, et al. A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy. Am J Obstet Gynecol. 2008;199:357.e1–7.Google Scholar