Diagnostic performance of ultrasonography in pre-operative assessment of lymph nodes in patients with cervical cancer

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F24%3AW0000024" target="_blank" >RIV/00064211:_____/24:W0000024 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/24:00136694 RIV/00216208:11110/24:10483201 RIV/00064165:_____/24:10483201

Výsledek na webu

<a href="https://oadoi.org/10.1136/ijgc-2024-005341" target="_blank" >https://oadoi.org/10.1136/ijgc-2024-005341</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/ijgc-2024-005341" target="_blank" >10.1136/ijgc-2024-005341</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Diagnostic performance of ultrasonography in pre-operative assessment of lymph nodes in patients with cervical cancer

Popis výsledku v původním jazyce

Objectives To assess the diagnostic performance of ultrasonography in pre-operative assessment of lymph nodes in patients with cervical cancer, to compare the outcomes for pelvic and para-aortic regions, and to detect macrometastases and micrometastases separately. Methods Patients were retrospectively included if they met the following inclusion criteria: pathologically verified cervical cancer; ultrasonography performed by one of four experienced sonographers; surgical lymph node staging, at least in the pelvic region-sentinel lymph node biopsy or systematic pelvic lymphadenectomy or debulking. The final pathological examination was the reference standard. Results 390 patients met the inclusion criteria between 2009 and 2019. Pelvic node macrometastases (>= 2 mm) were confirmed in 54 patients (13.8%), and micrometastases (>= 0.2 mm and <2 mm) in another 21 patients (5.4%). Ultrasonography had sensitivity 72.2%, specificity 94.0%, and area under the curve (AUC) 0.831 to detect pelvic macrometastases, while sensitivity 53.3%, specificity 94.0%, and AUC 0.737 to detect both pelvic macrometastases and micrometastases (pN1). Ultrasonography failed to detect pelvic micrometastases, with sensitivity 19.2%, specificity 85.2%, and AUC 0.522. There was no significant impact of body mass index on diagnostic accuracy. Metastases in para-aortic nodes (macrometastases only) were confirmed in 16 of 71 patients who underwent para-aortic lymphadenectomy. Ultrasonography yielded sensitivity 56.3%, specificity 98.2%, and AUC 0.772 to identify para-aortic node macrometastases. Conclusion Ultrasonography performed by an experienced sonographer can be considered a sufficient diagnostic tool for pre-operative assessment of lymph nodes in patients with cervical cancer, showing similar diagnostic accuracy in detection of pelvic macrometastases as reported for other imaging methods (18F-fluorodeoxyglucose positron emission tomography/CT or diffusion-weighted imaging/MRI). It had low sensitivity for detection of small-volume macrometastases (largest diameter <5 mm) and micrometastases. The accuracy of para-aortic assessment was comparable to that for pelvic lymph nodes, and assessment of the para-aortic region should be an inseparable part of the examination protocol.

Název v anglickém jazyce

Diagnostic performance of ultrasonography in pre-operative assessment of lymph nodes in patients with cervical cancer

Popis výsledku anglicky

Objectives To assess the diagnostic performance of ultrasonography in pre-operative assessment of lymph nodes in patients with cervical cancer, to compare the outcomes for pelvic and para-aortic regions, and to detect macrometastases and micrometastases separately. Methods Patients were retrospectively included if they met the following inclusion criteria: pathologically verified cervical cancer; ultrasonography performed by one of four experienced sonographers; surgical lymph node staging, at least in the pelvic region-sentinel lymph node biopsy or systematic pelvic lymphadenectomy or debulking. The final pathological examination was the reference standard. Results 390 patients met the inclusion criteria between 2009 and 2019. Pelvic node macrometastases (>= 2 mm) were confirmed in 54 patients (13.8%), and micrometastases (>= 0.2 mm and <2 mm) in another 21 patients (5.4%). Ultrasonography had sensitivity 72.2%, specificity 94.0%, and area under the curve (AUC) 0.831 to detect pelvic macrometastases, while sensitivity 53.3%, specificity 94.0%, and AUC 0.737 to detect both pelvic macrometastases and micrometastases (pN1). Ultrasonography failed to detect pelvic micrometastases, with sensitivity 19.2%, specificity 85.2%, and AUC 0.522. There was no significant impact of body mass index on diagnostic accuracy. Metastases in para-aortic nodes (macrometastases only) were confirmed in 16 of 71 patients who underwent para-aortic lymphadenectomy. Ultrasonography yielded sensitivity 56.3%, specificity 98.2%, and AUC 0.772 to identify para-aortic node macrometastases. Conclusion Ultrasonography performed by an experienced sonographer can be considered a sufficient diagnostic tool for pre-operative assessment of lymph nodes in patients with cervical cancer, showing similar diagnostic accuracy in detection of pelvic macrometastases as reported for other imaging methods (18F-fluorodeoxyglucose positron emission tomography/CT or diffusion-weighted imaging/MRI). It had low sensitivity for detection of small-volume macrometastases (largest diameter <5 mm) and micrometastases. The accuracy of para-aortic assessment was comparable to that for pelvic lymph nodes, and assessment of the para-aortic region should be an inseparable part of the examination protocol.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

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OECD FORD obor

30204 - Oncology

Projekt

<a href="/cs/project/NU21-03-00461" target="_blank" >NU21-03-00461: CANNES Cervical Cancer Lymph Node Staging: Prospektivní multicentrická zobrazovací studie srovnávající diagnostickou přesnost ultrazvukového vyšetření, MRI a PET/CT v předoperačním hodnocení lymfatických uzlin u pacientek s karcinomem děložního hrdla</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER

ISSN

1048-891X

e-ISSN

1525-1438

Svazek periodika

34

Číslo periodika v rámci svazku

7

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

8

Strana od-do

985-992

Kód UT WoS článku

001265086900013

EID výsledku v databázi Scopus

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