1. The impact of low-volume metastasis on disease-free survival of women with early-stage cervical cancer.
- Author
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Buda A, Casarin J, Mueller M, Fanfani F, Zapardiel I, Mereu L, Puppo A, De Ponti E, Adorni M, Ferrari D, Gasparri ML, Ghezzi F, Scambia G, and Papadia A
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma pathology, Adenocarcinoma therapy, Adult, Carcinoma, Adenosquamous diagnosis, Carcinoma, Adenosquamous pathology, Carcinoma, Adenosquamous therapy, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Case-Control Studies, Disease-Free Survival, Female, Humans, Lymph Nodes pathology, Lymphatic Metastasis, Middle Aged, Neoplasm Micrometastasis therapy, Neoplasm Staging, Prognosis, Retrospective Studies, Sentinel Lymph Node Biopsy, Tumor Burden, Uterine Cervical Neoplasms diagnosis, Neoplasm Micrometastasis diagnosis, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms therapy
- Abstract
Purpose: We aimed to assess the impact of low-volume metastasis (micrometastasis and isolated tumor cells) on disease-free survival (DFS) of women with early-stage cervical cancer., Methods: Women with clinically suspected stage 1A-IB2 (FIGO 2018 classification) disease who underwent retroperitoneal nodal staging between October 2010 and April 2018, were retrospectively analyzed. The group of women who had undergone lymphadenectomy and standard node pathologic analysis (H&E group), were compared to the group undergoing sentinel node mapping (SLN) and ultrastaging with or without lymphadenectomy (ultrastaging group). At a median follow-up of 45 months, the DFS curves were analyzed., Results: Overall, 573 patients were revised (272 in the H&E group and 302 in the ultrastaging group). Eighty-five patients presented lymph node metastasis (32 in H&E, 53 in ultrastaging). Ultrastaging protocol increased the rate of low-volume metastasis by 5.6%. Twenty patients showed exclusive micrometastasis or ITC's. Seventy-three recurrences occurred (35 in H&E, 38 in ultrastaging). Only 1 out of 53 patients in the ultrastaging group (1.9%) presented with micrometastasis recurred. The 3-year disease-free survival was 89% for the H&E group, and 88% for the ultrastaging group, respectively (p = 0.175)., Conclusion: Ultrastaging analysis allowed increasing the detection of low volume metastasis in women with early-stage cervical cancer. However, the type of nodal staging did not have an impact on patients' 3-year disease-free survival.
- Published
- 2021
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