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- Title
Intra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical cancer.
- Authors
Lv X; Chen L; Yu H; Zhang X; Yan D; Lv, Xiaojuan; Chen, Lu; Yu, Hua; Zhang, Xiang; Yan, Dingding
- Abstract
<bold>Introduction: </bold>To evaluate frozen section analysis of common iliac lymph nodes for developing the accuracy of para-aortic lymphadenectomy and detection of para-aortic lymph node metastasis in patients with stage IB1 and IIA1 cervical cancer treated by surgical intent.<bold>Methods: </bold>Three hundred and ninety-two patients with stage IB1 and IIA1 cervical cancer who underwent radical hysterectomy with pelvic and/or para-aortic lymphadenectomy were retrospectively analyzed. Among those patients, 183 (group A) underwent para-aortic lymphadenectomy when para-aortic lymph nodes were identified as suspicious by visualization and palpation. Other 209 patients (group B, underwent intra-operative frozen section analysis of common iliac lymph nodes) underwent para-aortic lymphadenectomy when frozen section analysis was positive, or para-aortic lymph nodes were identified as suspicious metastases by visualization and palpation.<bold>Results: </bold>We found 21 positive cases (10.0%) of 209 patients by frozen section examination, represented by 1 false negative (4.5%) and 0 false positive case. The specificity and the positive predictive value of frozen section examination were 100%; the negative predictive value was 99.5% (187/188). Overall, the metastasis rates of pelvic lymph node, common iliac lymph node, and para-aortic lymph node were 35.7, 10.2, and 3.3%, respectively. We found the dissection and metastasis rates of para-aortic lymph node in group B statistically significantly higher than group A (14.4% vs. 7.1%, for dissection rates of group B vs. group A, P = 0.022) (5.3% vs. 1.1%, for metastasis rates of group B vs. group A, P = 0.021).<bold>Conclusion: </bold>The frozen section analysis of common iliac lymph nodes can develop the accuracy of the para-aortic lymphadenectomy and metastasis rate of para-aortic lymph node in patients with stage IB1 and IIA1 cervical cancer.
- Publication
Archives of Gynecology & Obstetrics, 2012, Vol 285, Issue 3, p811
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-011-2038-z