SCC-Ag, lymph node metastases and sentinel node procedure in early stage squamous cell cervical cancer
Autor: | Silvia von Mensdorff-Pouilly, Tatjana J. Water, W. Marchien van Baal, Jonas van de Lande, Elvira M. Davelaar, Peter Kenemans, René H.M. Verheijen, Johannes Berkhof |
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Přispěvatelé: | Obstetrics and gynaecology, Epidemiology and Data Science, ICaR - Ischemia and repair |
Rok vydání: | 2009 |
Předmět: |
Oncology
Adult medicine.medical_specialty medicine.medical_treatment Sentinel lymph node Uterine Cervical Neoplasms Gastroenterology Young Adult Antigens Neoplasm Internal medicine medicine Carcinoma Humans Stage (cooking) Lymph node Serpins Aged Neoplasm Staging Proportional Hazards Models Cervical cancer Aged 80 and over Proportional hazards model business.industry Sentinel Lymph Node Biopsy Obstetrics and Gynecology Sentinel node Middle Aged medicine.disease Prognosis medicine.anatomical_structure Lymphatic Metastasis Carcinoma Squamous Cell Lymph Node Excision Lymphadenectomy Female Lymph Nodes business |
Zdroj: | van de Lande, J, Davelaar, E M, von Mensdorff-Pouilly, S, Water, T J, Berkhof, J, van Baal, W M, Kenemans, P & Verheijen, R H 2009, ' SCC-Ag, lymph node metastases and sentinel node procedure in early stage squamous cell cervical cancer ', Gynecologic Oncology, vol. 112, no. 1, pp. 119-125 . https://doi.org/10.1016/j.ygyno.2008.09.042 Gynecologic Oncology, 112(1), 119-125. Academic Press Inc. |
ISSN: | 0090-8258 |
DOI: | 10.1016/j.ygyno.2008.09.042 |
Popis: | Objectives We analyzed pretreatment SCC-Ag levels, lymph node (LN) status and disease outcome in early stage squamous cell (SCC) cervical cancer. Methods Serum SCC-Ag was measured before primary treatment in 91 patients (FIGO stage IB1 72, IB2 10, and IIA 9). Of these, 58 underwent laparoscopic sentinel lymph node (SLN) procedure followed by pelvic lymphadenectomy. Results No false negative SLN were observed. SCC-Ag levels were higher in patients with positive LN compared to patients with negative LN (p = 0.010), but no difference was found in the SLN patients (p = 0.344). The accuracy to predict LN metastases of SCC-Ag at ROC established cutoff of 1.65 ng/mL and 5.5 ng/mL was 76% and 78%, respectively, in stage IB1, and 53% and 79%, respectively, in stages IB2+ IIA. Whereas no deaths were observed in patients with negative LN and negative SCC-Ag levels (at previously established cutoff of 1.1 ng/mL), overall survival (OS) for patients with negative LN but elevated SCC-Ag was similar to that of patients with positive LN, irrespective of their marker levels (Kaplan–Meier analysis of all patients and in stage IB1, p = 0.002 and p = 0.026, respectively). Conclusions SCC-Ag (> 1.65 ng/mL) can predict LN metastases more accurately in stage IB1 than in stage IB2+ IIA. Since SCC-Ag levels above 1.1 ng/mL are already associated with a poor prognosis, the marker seems to identify a subgroup of LN negative patients with occult disease that may benefit from full lymphadenectomy following a SLN procedure. |
Databáze: | OpenAIRE |
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