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Lymph Node Involvement in Locally Advanced Cervical Cancer Patients Administered Preoperative Chemoradiation versus Chemotherapy

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Abstract

Background

A retrospective study was planned in 127 locally advanced cervical cancer (LACC) to investigate: (1) the rate and pattern of metastatic lymphnode involvement in patients administered preoperative chemoradiation (CT/RT) versus neoadjuvant chemotherapy (NACT), and (2) the profile of clinico-pathological parameters predictive of metastatic lymph node involvement in these two clinical settings. Finally, we investigated whether the pathologically assessed status of lower pelvic nodes (LPN) was able to predict the pathologically assessed status of upper pelvic nodes (UPN) and parametrium in cases administered CT/RT.

Methods

Patients were selected including LACC patients who were administered concomitant CT/RT (n = 87) or NACT (n = 40), before radical surgery.

Results

Metastatic pelvic lymphnode involvement was significantly lower in cases administered CT/RT (11.5%) compared to cases administered NACT (30.0%) (P value = 0.009). In the CT/RT group, only MRI-assessed pelvic node status (both at staging and post-treatment evaluation) was associated with pathologic pelvic node status. In patients administered CT/RT, the status of LPN appeared associated with the status of UPN.

Conclusions

(1) Preoperative CT/RT treatment is associated with a lower rate of pelvic node disease in LACC patients compared to NACT; (2) there is no association between the preoperative extent of residual cervical disease after CT/RT and pathologically assessed pelvic node status; (3) the pathological status of LPN is predictive of the pathological status of UPN and parametrium.

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Authors and Affiliations

  1. Gynecologic Oncology Unit, Catholic University of Rome, L.go A. Gemelli 8, 00168, Rome, Italy

    Gabriella Ferrandina MD, Mariagrazia Distefano MD & Manuela Ludovisi MD

  2. Division of Radiotherapy, Catholic University of Rome, Rome, Italy

    Daniela Smaniotto MD & Giuseppe D’Agostino MD

  3. Division of Radiotherapy, Catholic University of Campobasso, Campobasso, Italy

    Gabriella Ferrandina MD & Alessio Morganti MD

  4. Department of Oncology, Catholic University of Campobasso, Campobasso, Italy

    Francesco Fanfani MD & Giovanni Scambia MD

Authors
  1. Gabriella Ferrandina MD
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  2. Mariagrazia Distefano MD
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  3. Manuela Ludovisi MD
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  4. Alessio Morganti MD
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  5. Daniela Smaniotto MD
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  6. Giuseppe D’Agostino MD
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  7. Francesco Fanfani MD
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  8. Giovanni Scambia MD
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Corresponding author

Correspondence to Gabriella Ferrandina MD.

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Ferrandina, G., Distefano, M., Ludovisi, M. et al. Lymph Node Involvement in Locally Advanced Cervical Cancer Patients Administered Preoperative Chemoradiation versus Chemotherapy. Ann Surg Oncol 14, 1129–1135 (2007). https://doi.org/10.1245/s10434-006-9252-0

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  • DOI: https://doi.org/10.1245/s10434-006-9252-0

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