1. Tertiary prevention strategies for micrometastatic lymph node cervical cancer: A systematic review and a prototype of an adapted model of care.
- Author
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Śniadecki M, Guani B, Jaworek P, Klasa-Mazurkiewicz D, Mahiou K, Mosakowska K, Buda A, Poniewierza P, Piątek O, Crestani A, Stasiak M, Balaya V, Musielak O, Piłat L, Maliszewska K, Aristei C, Guzik P, Wojtylak S, Liro M, Gaillard T, Kocian R, Gołąbiewska A, Chmielewska Z, and Wydra D
- Subjects
- Female, Humans, Lymph Nodes pathology, Neoplasm Recurrence, Local prevention & control, Neoplasm Recurrence, Local pathology, Prognosis, Tertiary Prevention methods, Lymphatic Metastasis, Neoplasm Micrometastasis pathology, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms prevention & control
- Abstract
Purpose: We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases., Methodology: We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases. The electronic databases for literature and relevant articles were analysed., Results: Fifteen studies, (4882 patients), were included in our systematic review. While the results show that MICs significantly worsen prognosis in early CC. A tertiary prevention algorithm for low volume lymph node disease may stratify follow-up according to the burden of nodal disease and provide data that helps improve follow-up performance., Conclusion: MICs worsen prognosis and should be managed as suggested by the algorithm. However, this algorithm must be externally validated. The clinical impact of isolated tumor cells (ITC) remains unclear., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Published
- 2024
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