Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Resection of the upper paracervical lymphovascular tissue should be an integral part of a pelvic sentinel lymph node algorithm in early stage cervical cancer

Lührs, Oscar LU ; Ekdahl, Linnea LU orcid ; Geppert, Barbara LU ; Lönnerfors, Céline LU and Persson, Jan LU (2021) In Gynecologic Oncology 163(2). p.289-293
Abstract

Objective: To investigate the prevalence of lymph nodes and lymph node metastases (LNMs) in the upper paracervical lymphovascular tissue (UPLT) in early stage cervical cancer. Methods: In this prospective study consecutive women with stage IA1-IB1 cervical cancer underwent a pelvic lymphadenectomy including identification of sentinel nodes (SLNs) as part of a nodal staging procedure in conjunction with a robotic radical hysterectomy (RRH) or robotic radical trachelectomy (RRT). Indocyanine green (ICG) was used as tracer. The UPLT was separately removed and defined as “SLN-parametrium” and, as all SLN tissue, subjected to ultrastaging and immunohistochemistry. Primary endpoint was prevalence of lymph nodes and metastatic lymph nodes in... (More)

Objective: To investigate the prevalence of lymph nodes and lymph node metastases (LNMs) in the upper paracervical lymphovascular tissue (UPLT) in early stage cervical cancer. Methods: In this prospective study consecutive women with stage IA1-IB1 cervical cancer underwent a pelvic lymphadenectomy including identification of sentinel nodes (SLNs) as part of a nodal staging procedure in conjunction with a robotic radical hysterectomy (RRH) or robotic radical trachelectomy (RRT). Indocyanine green (ICG) was used as tracer. The UPLT was separately removed and defined as “SLN-parametrium” and, as all SLN tissue, subjected to ultrastaging and immunohistochemistry. Primary endpoint was prevalence of lymph nodes and metastatic lymph nodes in the UPLT. Secondary endpoints were complications associated with removal of the UPLT. Results: One hundred and forty-five women were analysed. Nineteen (13.1%) had pelvic LNMs, all identified by at least one metastatic SLN. In 76 women (52.4%) at least one UPLT lymph node was identified. Metastatic UPLT lymph nodes were identified in six women of which in three women (2.1% of all women and 15.8% of node positive women) without lateral pelvic LNMs. Thirteen women had lateral pelvic SLN LNMs with either no (n = 5) or benign (n = 8) UPLT lymph nodes. No intraoperative complications occurred due to the removal of the UPLT. Conclusion: Removal of the UPLT should be an integral part of the SLN concept in early stage cervical cancer.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cervical cancer, Indocyanine green, Sentinel lymph node biopsy, Upper paracervical lymphovascular tissue
in
Gynecologic Oncology
volume
163
issue
2
pages
289 - 293
publisher
Academic Press
external identifiers
  • scopus:85115795120
  • pmid:34509298
ISSN
0090-8258
DOI
10.1016/j.ygyno.2021.08.031
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Authors
id
ba34866c-72e2-4e9b-b1ef-110e0d6b9a20
date added to LUP
2021-10-20 10:55:38
date last changed
2024-04-20 13:29:17
@article{ba34866c-72e2-4e9b-b1ef-110e0d6b9a20,
  abstract     = {{<p>Objective: To investigate the prevalence of lymph nodes and lymph node metastases (LNMs) in the upper paracervical lymphovascular tissue (UPLT) in early stage cervical cancer. Methods: In this prospective study consecutive women with stage IA1-IB1 cervical cancer underwent a pelvic lymphadenectomy including identification of sentinel nodes (SLNs) as part of a nodal staging procedure in conjunction with a robotic radical hysterectomy (RRH) or robotic radical trachelectomy (RRT). Indocyanine green (ICG) was used as tracer. The UPLT was separately removed and defined as “SLN-parametrium” and, as all SLN tissue, subjected to ultrastaging and immunohistochemistry. Primary endpoint was prevalence of lymph nodes and metastatic lymph nodes in the UPLT. Secondary endpoints were complications associated with removal of the UPLT. Results: One hundred and forty-five women were analysed. Nineteen (13.1%) had pelvic LNMs, all identified by at least one metastatic SLN. In 76 women (52.4%) at least one UPLT lymph node was identified. Metastatic UPLT lymph nodes were identified in six women of which in three women (2.1% of all women and 15.8% of node positive women) without lateral pelvic LNMs. Thirteen women had lateral pelvic SLN LNMs with either no (n = 5) or benign (n = 8) UPLT lymph nodes. No intraoperative complications occurred due to the removal of the UPLT. Conclusion: Removal of the UPLT should be an integral part of the SLN concept in early stage cervical cancer.</p>}},
  author       = {{Lührs, Oscar and Ekdahl, Linnea and Geppert, Barbara and Lönnerfors, Céline and Persson, Jan}},
  issn         = {{0090-8258}},
  keywords     = {{Cervical cancer; Indocyanine green; Sentinel lymph node biopsy; Upper paracervical lymphovascular tissue}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{289--293}},
  publisher    = {{Academic Press}},
  series       = {{Gynecologic Oncology}},
  title        = {{Resection of the upper paracervical lymphovascular tissue should be an integral part of a pelvic sentinel lymph node algorithm in early stage cervical cancer}},
  url          = {{http://dx.doi.org/10.1016/j.ygyno.2021.08.031}},
  doi          = {{10.1016/j.ygyno.2021.08.031}},
  volume       = {{163}},
  year         = {{2021}},
}