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- Title
Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial.
- Authors
Tsunoda, audrey Tieko; Marnitz, Simone; Soares Nunes, Joao; Mattos de Cunha andrade, Carlos Eduardo; Scapulatempo Neto, Christovam; Blohmer, Jens-Uwe; Herrmann, Jörg; Kerr, Ligia Maria; Martus, Peter; Schneider, achim; Favero, Giovanni; Köhler, Christhardt
- Abstract
Background: Surgical staging is associated with a significant rate of upstaging compared to clinical/radiological staging in patients with locally advanced cervical cancer. Objective: To analyze the stage-specific percentage of pelvic and paraaortic lymph node metastases and the upstaging ratio in a prospective randomized trial (Uterus-11). Methods: FIGO stage IIB-IVA cervical cancer patients were randomized to surgical staging (arm A) or to clinical staging and primary chemoradiation (arm B). Arm B patients underwent CT-guided biopsy of suspicious para-aortic lymph nodes. Confirmed para-aortic metastasis patients received extended-field radiation therapy. Results: A total of 234 patients were enrolled, including 120 (arm A) and 114 (arm B) treated per protocol. The groups were well balanced. Pelvic and para-aortic lymph node metastases were identified after surgical staging in 51 and 24% of patients, respectively (p < 0.001). Pelvic and para-aortic lymph node metastases were confirmed in 45 and 20% of IIB patients and in 71 and 37% of IIIB patients, respectively. Upstaging occurred in 39/120 (33%) in arm A and in 9/114 (8%) in arm B (p < 0.001). Conclusion: The histological results in both groups led to a considerable rate of upstaging. Oncological data from the Uterus-11 study may reveal whether modified therapy translates into a survival benefit.
- Subjects
LYMPH node surgery; BIOPSY; HISTOLOGY; LAPAROSCOPIC surgery; LONGITUDINAL method; LYMPH nodes; METASTASIS; PELVIC tumors; TUMOR classification; CERVIX uteri tumors; RANDOMIZED controlled trials; TREATMENT effectiveness; CHEMORADIOTHERAPY
- Publication
Oncology, 2017, Vol 92, Issue 4, p213
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000453666