Incidence of Mesorectal Node Metastasis in Locally Advanced Cervical Cancer: Its Therapeutic Implications
| Autor: | Michelle M. McNamara, Samuel Jang, O.C. Barrett, Robert Y. Kim, Jessica G. Zarzour, O. Lee Burnett, Francisco Cordero-Gallardo, Sejong Bae, Therese M Weber, Andrew M. McDonald |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty Node metastasis Locally advanced Uterine Cervical Neoplasms Standardized uptake value Mesorectum 030218 nuclear medicine & medical imaging Metastasis Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Mesorectal Aged 80 and over Cervical cancer Radiation Rectal Neoplasms business.industry Incidence Incidence (epidemiology) Obstetrics and Gynecology Retrospective cohort study Chemoradiotherapy Middle Aged Prognosis medicine.disease United States Lymphatic Metastasis 030220 oncology & carcinogenesis Female Lymph Nodes Radiology business Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 102:e627 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2018.07.1714 |
| Popis: | ObjectiveTo evaluate the incidence and risk factors for mesorectal node metastasis (MRNM) in locally advanced cervical cancer.Methods/MaterialsWe performed an observational retrospective cohort study of 122 patients with cervical cancer who received definitive chemo-radiation treatment between December 2013 and June 2017 to evaluate the incidence of MRNM. Three diagnostic radiologists assessed all available pre-treatment images. In this study, the pelvic node metastasis was defined as ≥ 1.0 cm and MRNM as ≥ 0.5 cm for CT and MRI scans and as a maximum standardized uptake value of > 2.5 for PET/CT. The relationship of MRNM with FIGO stage, pelvic node metastasis, and mesorectal fascia involvement was evaluated.ResultsThe incidence of MRNM in all 122 patients was 8 (6.6%). However, in advanced stage (III– IV) patients, MRNM occurred in 4 of 39 (10.3%) compared with 4 of 83 (4.8%) in early stage (IB1–IIB) patients (p = 0.27). In patients with a positive pelvic node, MRNM occurred in 7 of 55 (12.7%) and 1 of 67 (1.5%) in those with negative pelvic node (p = 0.02). In addition, the incidence of MRNM was 3 of 9 (33.3%) in the presence of mesorectal fascia involvement and 5 of 113 (4.4%) among those without mesorectal fascia involvement (p = 0.013).ConclusionThis study indicates that pelvic node metastasis and mesorectal fascia involvement are high-risk factors for MRNM. Therefore, vigilance of reviewing images in the mesorectum for MRNM is necessary for high-risk patients. |
| Databáze: | OpenAIRE |
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