Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Population Study
2.2. Data Analysis
2.3. Statistical Analysis
3. Results
3.1. Clinicopathological Characteristics
3.2. Predictive Factors for Overall SLN Involvement
3.3. Predictive Factors for Micrometastatic and Macrometastic SLN Involvement
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Predictive Variable | Total Population n = 161 | |
---|---|---|
n Mean ± SD | [%] [Range] | |
Age [yrs] | ||
Mean | 40.9 ± 10.5 | [22–79] |
BMI [kg/m2] | ||
Mean | 23.3 ± 4.9 | [15.6–42.2] |
<18.5 | 12 | 7.5 |
18.5–25 | 111 | 68.9 |
<25–30 | 21 | 13.0 |
>30 | 17 | 10.6 |
Parity status | ||
0 | 46 | 28.6 |
≥1 | 125 | 71.4 |
Histology | ||
Squamous cell carcinoma | 123 | 76.3 |
Adenocarcinoma | 36 | 22.5 |
Other type | 2 | 1.3 |
Grade of differenciation | ||
G1 | 56 | 52.3 |
G2 | 37 | 34.6 |
G3 | 14 | 13.1 |
Not specified | 54 | |
Clinical 2018 FIGO stage | ||
IA1 with LVSI | 11 | 6.8 |
IA2 | 19 | 11.8 |
IB1 | 114 | 70.8 |
IB2 | 17 | 10.6 |
Conization specimens pathologic examination | ||
Tumor size | ||
Mean (mm) | 13.1 ± 7.7 | [1–40] |
<20 mm | 118 | 73.3 |
≥20 mm | 43 | 26.7 |
Depth of stromal invasion | ||
Mean (mm) | 6.6 ± 6.0 | [0–40] |
<10 mm | 129 | 80.1 |
≥10 mm | 32 | 19.9 |
LVSI | ||
Yes | 49 | 30.4 |
No | 112 | 69.6 |
Margin status | ||
Positive | 58 | 48.7 |
Negative | 79 | 51.3 |
Not specified | 24 | |
Surgery | ||
Type of approach | ||
Minimally invasive | 150 | 93.2 |
Open | 11 | 6.8 |
Type of surgery | ||
Radical hysterectomy | 110 | 72.4 |
Radical trachelectomy | 30 | 19.7 |
Simple hysterectomy | 6 | 3.9 |
Simple trachelectomy | 3 | 2.0 |
Not performed | 2 | 1.3 |
Not specified | 9 | |
SLN mapping | ||
Median number of SLN harvested per patient | 3 | [2–8] |
SLN status | ||
Negative | 146 | 90.7 |
ITCs | 5 | 3.1 |
Micrometastases | 6 | 3.7 |
Macrometastases | 4 | 2.5 |
Final surgical specimens pathologic examination | ||
Residual disease | ||
Yes | 48 | 33.3 |
No | 96 | 66.7 |
Not specified | 17 | |
Tumor size | ||
Median (mm) | 12 | [1–50] |
<20 mm | 30/48 | 62.5 |
≥20 mm | 18/48 | 37.5 |
Depth of stromal invasion | ||
Mean (mm) | 6.5 | [0–32] |
<10 mm | 29/48 | 60.4 |
≥10 mm | 19/48 | 39.6 |
LVSI | ||
Yes | 50 | 32.9 |
No | 102 | 67.1 |
Not specified | 9 | |
Margin status | ||
Positive | 4 | 2.5 |
Negative | 155 | 97.5 |
Not specified | 2 |
Predictive Variable | Patients with SLN − n = 146 | Patients with SLN + n = 15 | p | ||
---|---|---|---|---|---|
n Mean ± SD | [%] [Range] | n Mean ± SD | [%] [Range] | ||
Age [yrs] | |||||
Mean | 41.0 ± 10.2 | [22–79] | 39.9 ± 13.7 | [25–77] | 0.71 |
BMI [kg/m2] | |||||
Mean | 23.3 ± 5.0 | [15.6–42.2] | 23.8 ± 4.6 | [18.7–33.7] | 0.74 |
Parity status | |||||
0 | 41 | 28.1 | 5 | 33.3 | 0.67 |
≥1 | 105 | 71.9 | 10 | 66.7 | |
Histology | |||||
Squamous cell carcinoma | 112 | 76.6 | 11 | 73.3 | 0.84 |
Adenocarcinoma | 32 | 22.1 | 4 | 26.7 | |
Other type | 2 | 1.4 | 0 | 0.0 | |
Grade of differenciation | |||||
G1 | 52 | 54.2 | 4 | 36.4 | 0.34 |
G2 | 31 | 32.3 | 6 | 54.5 | |
G3 | 13 | 13.5 | 1 | 9.1 | |
Not specified | 50 | 4 | |||
Clinical 2018 FIGO stage | |||||
IA1 with LVSI | 11 | 7.5 | 0 | 0.0 | 0.14 |
IA2 | 17 | 11.6 | 2 | 13.3 | |
IB1 | 105 | 71.9 | 9 | 60.0 | |
IB2 | 13 | 8.9 | 4 | 26.7 | |
Conization specimens pathologic examination | |||||
Tumor size | |||||
Mean (mm) | 13.0 ± 7.7 | [1–40] | 15.1 ± 7.8 | [4–30] | 0.31 |
<20 mm | 107 | 73.3 | 11 | 73.3 | 0.99 |
≥20 mm | 39 | 26.7 | 4 | 26.7 | |
Depth of stromal invasion | |||||
Mean (mm) | 6.3 ± 6.0 | [0–40] | 9.6 ± 7.0 | [0–23] | 0.049 |
<10 mm | 120 | 82.2 | 9 | 60.0 | 0.04 |
≥10 mm | 26 | 17.8 | 6 | 40.0 | |
LVSI | |||||
Yes | 43 | 29.5 | 6 | 40.0 | 0.40 |
No | 103 | 70.5 | 9 | 60.0 | |
Margin status | |||||
Positive | 52 | 41.6 | 6 | 50.0 | 0.57 |
Negative | 73 | 58.4 | 6 | 50.0 | |
Not specified | 21 | 3 |
Predictive Variable | Patients with SLN − n = 146 | Patients with MIC or MAC n = 10 | p | ||
---|---|---|---|---|---|
n Mean ± SD | [%] [Range] | n Mean ± SD | [%] [Range] | ||
Age [yrs] | |||||
Mean | 41.0 ± 10.2 | [22–79] | 37.4 ± 10.2 | [25–54] | 0.28 |
BMI [kg/m2] | |||||
Mean | 23.3 ± 5.0 | [15.6–42.2] | 23.1 ± 5.5 | [18.7–33.7] | 0.88 |
Parity status | |||||
0 | 41 | 28.1 | 3 | 30.0 | 0.99 |
≥1 | 105 | 71.9 | 7 | 70.0 | |
Histology | |||||
Squamous cell carcinoma | 112 | 76.6 | 8 | 80.0 | 0.99 |
Adenocarcinoma | 32 | 22.1 | 2 | 20.0 | |
Other type | 2 | 1.4 | 0 | 0.0 | |
Grade of differenciation | |||||
G1 | 52 | 54.2 | 3 | 37.5 | 0.68 |
G2 | 31 | 32.3 | 4 | 50.0 | |
G3 | 13 | 13.5 | 1 | 12.5 | |
Not specified | 50 | 2 | |||
Clinical 2018 FIGO stage | |||||
IA1 with LVSI | 11 | 7.5 | 0 | 0.0 | 0.58 |
IA2 | 17 | 11.6 | 1 | 10.0 | |
IB1 | 105 | 71.9 | 7 | 70.0 | |
IB2 | 13 | 8.9 | 2 | 20.0 | |
Conization specimens pathologic examination | |||||
Tumor size | |||||
Mean (mm) | 13.0 ± 7.7 | [1–40] | 15.5 ± 8.3 | [4–30] | 0.32 |
<20 mm | 107 | 73.3 | 7 | 70.0 | 0.73 |
≥20 mm | 39 | 26.7 | 3 | 30.0 | |
Depth of stromal invasion | |||||
Mean (mm) | 6.3 ± 6.0 | [0–40] | 10.3 ± 5.9 | [4–20] | 0.04 |
<10 mm | 120 | 82.2 | 5 | 50.0 | 0.03 |
≥10 mm | 26 | 17.8 | 5 | 50.0 | |
LVSI | |||||
Yes | 43 | 29.5 | 6 | 60.0 | 0.048 |
No | 103 | 70.5 | 4 | 40.0 | |
Margin status | |||||
Positive | 52 | 41.6 | 6 | 66.7 | 0.17 |
Negative | 73 | 58.4 | 3 | 33.3 | |
Not specified | 21 | 1 |
DSI | Presence of LVSI | Risk of SLN + (%) | 95% CI | No. Total Patients | No. Patients with SLN+ | % of Patients with SLN+ | ||
---|---|---|---|---|---|---|---|---|
MIC | MAC | |||||||
Low-risk | <10 mm | No | 2.6 | 0.9–7.8 | 90 | 1 | 0 | 1.1 |
Intermediate-risk | <10 mm | Yes | 7.5 | 2.6–19.8 | 35 | 21 | 2 | 11.4 |
≥10 mm | No | 9.6 | 2.8–27.9 | 17 | 1 | 1 | 11.7 | |
High-risk | ≥10 mm | Yes | 24.1 | 9.6–48.6 | 14 | 2 | 1 | 21.4 |
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Balaya, V.; Guani, B.; Mereaux, J.; Magaud, L.; Pache, B.; Bonsang-Kitzis, H.; Ngô, C.; Desseauve, D.; Mathevet, P.; Lécuru, F.; et al. Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study. Cancers 2021, 13, 5423. https://doi.org/10.3390/cancers13215423
Balaya V, Guani B, Mereaux J, Magaud L, Pache B, Bonsang-Kitzis H, Ngô C, Desseauve D, Mathevet P, Lécuru F, et al. Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study. Cancers. 2021; 13(21):5423. https://doi.org/10.3390/cancers13215423
Chicago/Turabian StyleBalaya, Vincent, Benedetta Guani, Julie Mereaux, Laurent Magaud, Basile Pache, Hélène Bonsang-Kitzis, Charlotte Ngô, David Desseauve, Patrice Mathevet, Fabrice Lécuru, and et al. 2021. "Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study" Cancers 13, no. 21: 5423. https://doi.org/10.3390/cancers13215423