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
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00669806%3A_____%2F23%3A10451714" target="_blank" >RIV/00669806:_____/23:10451714 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/23:00130194 RIV/61988987:17110/23:A2402JVV RIV/00216208:11110/23:10451714 RIV/00216208:11140/23:10451714 and 2 more
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=~wf5uYccMn" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=~wf5uYccMn</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.ygyno.2022.11.017" target="_blank" >10.1016/j.ygyno.2022.11.017</a>
Alternative languages
Result language
angličtina
Original language name
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
Original language description
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 associ-ated with negative prognosis.Methods. We analyzed data from 967 cervical cancer patients (T1a1L1-T2b) registered in the SCCAN (Surveil-lance 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 be-tween 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 pa-tients, 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 com-pared to N0 in all subgroups with metastases >= 0.4 mm (HR 2.311, P = 0.04). The significance of metastases <0.4 mm could not be assessed due to limited statistical power (<80%). We did not identify any cut-off for the size of metastasis with significantly better prognosis than the rest of N1 group.Conclusions. In cervical cancer patients, the presence of LN metastases >= 0.4 mm was associated with a signif-icant negative impact on DFS and no cut-off value for the size of metastasis with better prognosis than N1 was found. Traditional metastasis stratification based on size has no clinical implication.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30214 - Obstetrics and gynaecology
Result continuities
Project
<a href="/en/project/NV19-03-00023" target="_blank" >NV19-03-00023: A prospective observational trial on sentinel lymph node biopsy in patients with early stage cervical cancer – Part 2</a><br>
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Gynecologic Oncology
ISSN
0090-8258
e-ISSN
1095-6859
Volume of the periodical
168
Issue of the periodical within the volume
January
Country of publishing house
US - UNITED STATES
Number of pages
6
Pages from-to
151-156
UT code for WoS article
000891635900010
EID of the result in the Scopus database
2-s2.0-85142735042