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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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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. |
format | Online Article Text |
id | pubmed-5265903 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
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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