1. Stratification of lymph node metastases as macrometastases, micrometastases, or isolated tumor cells has no clinical implication in patients with cervical cancer: Subgroup analysis of the SCCAN project
- Author
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Dostálek, Lukáš, Benešová, Klára, Klát, Jaroslav, Kim, Sarah H., Falconer, Henrik, Kostun, Jan, dos Reis, Ricardo, Zapardiel, Ignacio, Landoni, Fabio, Ortiz, David Isla, van Lonkhuijzen, Luc R. C. W., Lopez, Aldo, Odetto, Diego, Borčinová, Martina, Jarkovsky, Jiri, Salehi, Sahar, Němejcová, Kristýna, Bajsová, Sylva, Park, Kay J., Javůrková, Veronika, Abu-Rustum, Nadeem R., Dundr, Pavel, Cibula, David, Dostalek, L, Benesova, K, Klat, J, Kim, S, Falconer, H, Kostun, J, dos Reis, R, Zapardiel, I, Landoni, F, Ortiz, D, van Lonkhuijzen, L, Lopez, A, Odetto, D, Borcinova, M, Jarkovsky, J, Salehi, S, Nemejcova, K, Bajsova, S, Park, K, Javurkova, V, Abu-Rustum, N, Dundr, P, Cibula, D, Obstetrics and Gynaecology, and CCA - Cancer Treatment and Quality of Life
- Subjects
History ,Low volume metastasis ,Macrometastasi ,Polymers and Plastics ,Prognosi ,Disease-free survival ,Isolated tumor cells ,Macrometastasis ,Obstetrics and Gynecology ,Isolated tumor cell ,Classification ,Prognosis ,Industrial and Manufacturing Engineering ,Low volume metastasi ,Micrometastasis ,Micrometastasi ,Oncology ,Cervical cancer ,Histopathological ultrastaging ,Business and International Management ,Sentinel lymph node - Abstract
Background: In cervical cancer, presence of lymph-node macrometastases (MAC) is a major prognostic factor and an indication for adjuvant treatment. However, since clinical impact of micrometastases (MIC) and isolated tumor-cells (ITC) remains controversial, we sought to identify a cut-off value for the metastasis size not associated with negative prognosis. Methods: We analyzed data from 967 cervical cancer patients (T1a1L1-T2b) registered in the SCCAN (Surveillance in Cervical CANcer) database, who underwent primary surgical treatment, including sentinel lymph-node (SLN) biopsy with pathological ultrastaging. The size of SLN metastasis was considered a continuous variable and multiple testing was performed for cut-off values of 0.01-1.0 mm. Disease-free survival (DFS) was compared between N0 and subgroups of N1 patients defined by cut-off ranges. Results: LN metastases were found in 172 (18%) patients, classified as MAC, MIC, and ITC in 79, 54, and 39 patients, respectively. DFS was shorter in patients with MAC (HR 2.20, P = 0.003) and MIC (HR 2.87, P < 0.001), while not differing between MAC/MIC (P = 0.484). DFS in the ITC subgroup was neither different from N0 (P = 0.127) nor from MIC/MAC subgroups (P = 0.449). Cut-off analysis revealed significantly shorter DFS compared to N0 in all subgroups with metastases ≥0.4 mm (HR 2.311, P = 0.04). The significance of metastases
- Published
- 2023