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Patterns of lymph node metastasis in locally advanced cervical cancer

The aim of this study was to investigate patterns and locations of lymph node metastasis in locally advanced cervical cancers. A total of 244 consecutive patients with stage IIb cervical cancer were retrospectively evaluated. Contrast-enhanced CT scans were used for lymph node grading. Lymph nodes w...

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Autores principales: Liu, Zhikai, Hu, Ke, Liu, An, Shen, Jie, Hou, Xiaorong, Lian, Xin, Sun, Shuai, Yan, Junfang, Zhang, Fuquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265903/
https://www.ncbi.nlm.nih.gov/pubmed/27684810
http://dx.doi.org/10.1097/MD.0000000000004814
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author Liu, Zhikai
Hu, Ke
Liu, An
Shen, Jie
Hou, Xiaorong
Lian, Xin
Sun, Shuai
Yan, Junfang
Zhang, Fuquan
author_facet Liu, Zhikai
Hu, Ke
Liu, An
Shen, Jie
Hou, Xiaorong
Lian, Xin
Sun, Shuai
Yan, Junfang
Zhang, Fuquan
author_sort Liu, Zhikai
collection PubMed
description The aim of this study was to investigate patterns and locations of lymph node metastasis in locally advanced cervical cancers. A total of 244 consecutive patients with stage IIb cervical cancer were retrospectively evaluated. Contrast-enhanced CT scans were used for lymph node grading. Lymph nodes with the shortest axis (>1 cm) were categorized as positive and those between 0.5 and 1 cm were categorized as suspicious. All lymph nodes (LNs) were also classified by their anatomic locations. Nine hundred thirty-one LNs (136 positive and 795 suspicious) were identified. Sixty-three (25.8%) patients had positive LNs, and 153 (62.7%) patients had only suspicious LNs. The metastatic pattern was predictable traveling from level 1 (external iliac, internal iliac, obturator, and mesorectum groups) through level 2 (common iliac and presacral groups) to level 3 (para-aortic groups). In most groups, LNs were located within 1.0 cm of main blood vessels. Our novel findings were: presacral LNs metastases were rare (2/244, 0.82%); the left common iliac group (LCI) had significantly more enlarged nodes than the right common iliac group (P = 0.00); the LCI and left down-para-aortic group were further away from blood vessels than expected (1.2 cm and 1.4 cm, respectively); no additional margin was needed in anterolateral direction for external iliac groups. The lymph node metastatic patterns are relatively predicable. Different expansions from vessels should be used to include LNs for different groups. Presacral nodes metastases are rare, and further study is warranted to see whether this region can be excluded from nodal CTV.
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spelling pubmed-52659032017-02-06 Patterns of lymph node metastasis in locally advanced cervical cancer Liu, Zhikai Hu, Ke Liu, An Shen, Jie Hou, Xiaorong Lian, Xin Sun, Shuai Yan, Junfang Zhang, Fuquan Medicine (Baltimore) 5700 The aim of this study was to investigate patterns and locations of lymph node metastasis in locally advanced cervical cancers. A total of 244 consecutive patients with stage IIb cervical cancer were retrospectively evaluated. Contrast-enhanced CT scans were used for lymph node grading. Lymph nodes with the shortest axis (>1 cm) were categorized as positive and those between 0.5 and 1 cm were categorized as suspicious. All lymph nodes (LNs) were also classified by their anatomic locations. Nine hundred thirty-one LNs (136 positive and 795 suspicious) were identified. Sixty-three (25.8%) patients had positive LNs, and 153 (62.7%) patients had only suspicious LNs. The metastatic pattern was predictable traveling from level 1 (external iliac, internal iliac, obturator, and mesorectum groups) through level 2 (common iliac and presacral groups) to level 3 (para-aortic groups). In most groups, LNs were located within 1.0 cm of main blood vessels. Our novel findings were: presacral LNs metastases were rare (2/244, 0.82%); the left common iliac group (LCI) had significantly more enlarged nodes than the right common iliac group (P = 0.00); the LCI and left down-para-aortic group were further away from blood vessels than expected (1.2 cm and 1.4 cm, respectively); no additional margin was needed in anterolateral direction for external iliac groups. The lymph node metastatic patterns are relatively predicable. Different expansions from vessels should be used to include LNs for different groups. Presacral nodes metastases are rare, and further study is warranted to see whether this region can be excluded from nodal CTV. Wolters Kluwer Health 2016-09-30 /pmc/articles/PMC5265903/ /pubmed/27684810 http://dx.doi.org/10.1097/MD.0000000000004814 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5700
Liu, Zhikai
Hu, Ke
Liu, An
Shen, Jie
Hou, Xiaorong
Lian, Xin
Sun, Shuai
Yan, Junfang
Zhang, Fuquan
Patterns of lymph node metastasis in locally advanced cervical cancer
title Patterns of lymph node metastasis in locally advanced cervical cancer
title_full Patterns of lymph node metastasis in locally advanced cervical cancer
title_fullStr Patterns of lymph node metastasis in locally advanced cervical cancer
title_full_unstemmed Patterns of lymph node metastasis in locally advanced cervical cancer
title_short Patterns of lymph node metastasis in locally advanced cervical cancer
title_sort patterns of lymph node metastasis in locally advanced cervical cancer
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265903/
https://www.ncbi.nlm.nih.gov/pubmed/27684810
http://dx.doi.org/10.1097/MD.0000000000004814
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