Abstract:
OBJECTIVES:We aimed to determine the sentinel lymph node detection rates, accuracy in predicting the status of lymph node metastasis, and if pathologic ultrastaging improves the detection of micrometastases and isolated tumor cells at the time of primary surgery for cervical cancer. METHODS:A prospective, non-randomized study of women with early-stage (FIGO stage IA1 with lymphovascular space involvement--IIA) cervical carcinoma was conducted from June 2003 to August 2009. All patients underwent an intraoperative intracervical blue dye injection. Patients who underwent a preoperative lymphoscintigraphy received a 99m Tc sulfur colloid injection in addition. All patients underwent sentinel lymph node (SLN) identification followed by a complete pelvic node and parametrial dissection. SLN were evaluated using our institutional protocol that included pathologic ultrastaging. RESULTS:SLN mapping was successful in 77 (95%) of 81 patients. A total of 316 SLN were identified, with a median of 3 SLN per patient (range, 0-10 SLN). The majority (85%) of SLN were located at three main sites: the external iliac (35%); internal iliac (30%); and obturator (20%). Positive lymph nodes (LN) were identified in 26 (32%) patients, including 21 patients with positive SLN. Fifteen of 21 patients (71%) had SLN metastasis detected on routine processing. SLN ultrastaging detected metastasis in an additional 6/21 patients (29%). Two patients had grossly positive LN at exploration, and mapping was abandoned. Three of 26 (12%) patients had successful SLN mapping; however, the SLN failed to identify the metastatic LN. Of these 3 false negative cases, 2 patients had a metastatic parametrial node as the only positive LN with multiple negative pelvic nodes including negative SLN. One patient with stage IA1 disease and lymphovascular invasion had unilateral SLN mapping and a metastatic common iliac LN identified on completion lymphadenectomy of the contralateral side that did not map. The 4 (5%) patients with unsuccessful mapping included 1 who had grossly positive nodes identified at the time of laparotomy; the remaining 3 occurred during each surgeon's initial SLN mapping learning phase. CONCLUSION:SLN mapping in early-stage cervical carcinoma yields high detection rates. Ultrastaging improves micrometastasis detection. Parametrectomy and side-specific lymphadenectomy (in cases of failed mapping) remain important components of the surgical management of selected cases.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Diaz JP,Gemignani ML,Pandit-Taskar N,Park KJ,Murray MP,Chi DS,Sonoda Y,Barakat RR,Abu-Rustum NRdoi
10.1016/j.ygyno.2010.12.334subject
Has Abstractpub_date
2011-03-01 00:00:00pages
347-52issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(10)01217-5journal_volume
120pub_type
杂志文章abstract::For the past several years, all women with epithelial ovarian cancer have been treated identically, whether in a clinical trial or off protocol. Over the past decade, we have come to appreciate the magnitude of the heterogeneity of ovarian cancer. The development of the binary grading system for serous carcinoma was a...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2013.05.021
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The consequences of defective homologous recombination and other DNA repair pathways are important in disease outcomes of numerous tumor types. The objective of this study was to explore BRCA1, PARP, FANCD2, PTEN, H2AX, and ATM protein expression in endometrial cancer (EC). METHODS:PARP1, γH2AX, ATM, FANCD2,...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2014.02.002
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To construct a tool, using computed tomography (CT) imaging and preoperative clinical variables, to estimate successful primary cytoreduction for advanced epithelial ovarian cancer (EOC). METHODS:Women who underwent primary cytoreductive surgery for stage IIIC/IV EOC at Mayo Clinic between 1/2/2003 and 12/3...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.04.013
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:It has been postulated that gemcitabine inhibits DNA repair, and platinum resistance is due to increased DNA repair activity. The addition of gemcitabine to platinum-based agents may have synergistic tumoricidal activity. METHODS:Retrospective chart review of all patients with recurrent, persistent, or progr...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.07.056
更新日期:2004-12-01 00:00:00
abstract::Melanoma represents the second most frequent vulvar malignancy, and yet is still considered to be an uncommon neoplasm. Several varieties of melanoma exist. A patient who was diagnosed with a rare subtype of melanoma as a primary vulvar process is presented here. To date, there is only one other reported case of neuro...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1048
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVES:Epidermal Growth Factor Receptor (EGF-R) up-regulation in cervical cancer cells leads to an increase in cell proliferative Insulin-like Growth Factor II (IGF-II) and Vascular Endothelial Growth Factor (VEGF) and a decrease of the anti-proliferative IGF-binding protein-3 (IGF-BP3). The objectives for this stu...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.12.011
更新日期:2005-04-01 00:00:00
abstract::The purpose of this study was to obtain information about the public's awareness and perception of the discipline of gynecologic oncology. The marketing of cancer care and related services has resulted in substantial funding being allocated to market individual institutions. However, little has been done to educate pa...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90074-s
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:In this phase II study the efficacy and toxicity of an alternating chemotherapy regimen was examined in platinum-resistant relapsed epithelial ovarian cancer (EOC) patients. METHODS:Forty-five patients with platinum-refractory/resistant relapsed EOC, previously treated with carboplatin+paclitaxel+/-epirubici...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.03.003
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Women with cervical cancer constitute a patient population in need for ongoing, person-centred supportive care. Our aim was to synthesise current available evidence with regard to the supportive care needs of women living with and beyond cervical cancer. METHODS:A systematic review was conducted according t...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2014.10.030
更新日期:2015-03-01 00:00:00
abstract::The thoroughness of cytoreductive surgery is the largest contributor to survival for patients with advanced ovarian and primary peritoneal carcinoma. For many years the surgery undertaken by Gynaecologic Oncologists has been tailored to match their surgical training. Future surgical training of Gynaecologic Oncologist...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.11.007
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Angiomyolipoma is a distinctive benign neoplasm of the renal origin. Rare extrarenal instances of angiomyolipoma have been documented at various body sites. A case of extrarenal angiomyolipoma arising from the parametrial soft tissues is described in the present report. CASE:A woman, age 40 years, presented...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00251-8
更新日期:2003-07-01 00:00:00
abstract::A 65-year-old woman had a total abdominal hysterectomy and bilateral salpingo-oophorectomy through a Pfannenstiel incision for a Stage Ib, Grade 2 endometrial adenocarcinoma with extension to the middle third of the myometrium. No adjuvant treatment was given. She presented 7 years later with a large suprapubic mass a...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1994.1147
更新日期:1994-06-01 00:00:00
abstract::Considerable debate centers on the optimal treatment for vulvar melanoma, as well as those clinicopathological factors influencing prognosis. We reviewed 80 patients with vulvar melanoma seen between 1949 and 1990. Primary tumors were assessed according to Chung (47 patients) and Breslow (65 patients) microstaging sys...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90300-8
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:Previous studies suggest that differences in molecular features of endometrial cancers between racial groups may contribute to the poorer survival in Blacks. The objective of this investigation was to determine whether gene expression among endometrial cancers is different between Blacks and Whites. METHODS:...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.04.017
更新日期:2013-07-01 00:00:00
abstract::The objective of this study was to evaluate the prognostic value of a convenient nuclear grading system based on only the proportion of nuclei measuring more than 10 microm in length at the shortest axis in endometrial carcinomas. Of the 235 cases reviewed, 9 serous and 5 clear cell adenocarcinomas and 2 small cell ca...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4631
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:Uterine adenosarcomas (AS) are rare tumors composed of malignant stromal and benign epithelial components. We sought to evaluate the role of primary surgery, adjuvant treatments, and salvage therapies for patients with uterine adenosarcomas. METHODS:We identified all patients diagnosed with AS from 1990 to ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.12.036
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To assess toxicity and efficacy of weekly high-dose methotrexate-etoposide (HD MTX-ETO) in high-risk gestational trophoblastic neoplasia (GTN). METHODS:Retrospective chart review of high-risk GTN patients treated with HD MTX-ETO (methotrexate 1000 mg/m² day 1, etoposide 100 mg/m² days 1 and 2, q 1 wk). RESU...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.06.014
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Improvements in surgical technique of pelvic exenteration have mainly occurred in the reconstructive phase of the procedure. Quality of life seems to be improved when performing continent rather than non-continent urinary diversion [1]. Unfortunately, Miami continent urinary pouch is a surgical technique not...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.06.010
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to examine whether comorbidity is an independent prognostic factor for 3129 women diagnosed with ovarian cancer from 2005 to 2011. As Performance status (PS) might capture the impact of comorbidity we addressed whether comorbidity can be explained by PS or whether comorbidity has an i...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.12.039
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:This study explores patterns of lifestyle change and whether more threatening illness perceptions are associated with lifestyle changes post-treatment for smoking, alcohol consumption and Body Mass Index (BMI) among gynecological cancer patients. METHODS:In total, 395 cancer patients (N=221 endometrial; N=17...
journal_title:Gynecologic oncology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ygyno.2017.02.037
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To correlate findings on pathologic examination of loop electroexcisional procedure (LEEP) or cone biopsy specimens with residual disease in radical hysterectomy specimens in patients with stage IA2 cervical cancer to determine whether a subset of such patients may be eligible for conservative, fertility-spar...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.09.011
更新日期:2009-01-01 00:00:00
abstract::Between 1971 and 1979, seventy-four patients with metastatic or advanced recurrent sarcoma of uterine origin were treated with combination chemotherapy consisting of vincristine, actinomycin D, and cyclophosphamide (Cytoxan). The probability of survival at 2 and 5 years was 23 and 15%, respectively. The response rate ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(83)90078-1
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:While there is ample literature on prognostic factors for uterine cancer, currently there are nomeans to estimate an individual's risk for recurrence or to differentiate the risk of loco-regional recurrence from distant recurrence. We addressed this gap by developing nomograms to individualize the risk of rec...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.02.022
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:Our objective is to examine how selenium (Se) supplementation influences oxidative stress (malondialdehyde) and the glutathione peroxidase system in patients with ovarian cancer undergoing chemotherapy. MATERIAL:The study group included 31 patients with ovarian cancer undergoing chemotherapy receiving the dr...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ygyno.2003.12.013
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Split-thickness skin grafts are often utilized for vulvo-vaginal reconstruction. Unfortunately, infection and sloughing may occur in up to 22% of patients with standard techniques especially at irradiated recipient sites. CASES:We report seven cases of vulvo-vaginal reconstruction using split-thickness skin...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2005.03.021
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to estimate the clinical response rate and toxicity of daily tamoxifen combined with intermittent weekly medroxyprogesterone acetate (MPA). METHODS:This study reports the results of 61 patients with measurable advanced or recurrent endometrial carcinoma enrolled on this stu...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ygyno.2003.09.018
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:Placental-site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD). A risk-adapted treatment approach has been advocated, but controversy exists as to the most important prognostic markers for this disease. Our goal was to determine the prognostic markers for patients with...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.12.029
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Despite the fact that endometrial cancer commonly occurs in elderly women, little is known about the outcome of the oldest old, those > 80 years of age. We examined the patterns of care and outcome of the oldest old women with endometrial cancer. METHODS:An analysis of women > 65 years of age with endometrio...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.02.040
更新日期:2011-07-01 00:00:00
abstract::An improved assay for the measurement of human ovarian tumor antigen NB/70K (triton NB/70K assay) has been developed. This assay makes the accurate and reproducible estimation of serum NB/70K possible. Freezing and thawing of serum up to three times or refrigeration of diluted serum up to 7 days does not significantly...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90160-4
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the sensitivity of sentinel node (SN) ultrastaging and to define parameters that may reduce the overall false-negative rate in women with early-stage cervical cancer. METHODS:We analyzed data from a large retrospective multicenter cohort group with FIGO stages IA-IIB cervical cancer in whom at le...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2012.08.035
更新日期:2012-12-01 00:00:00