Intraoperative Detection of Lymph Nodes Metastasis in Early-Stage Cervical Cancer
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Abstract
The treatment of early-stage Cervical Cancer consists of Radical Surgery or Radiochemotherapy, both with similar outcomes. Surgical treatment is preferred in young patients to preserve ovarian and sexual function. The combination of both therapies significantly increases risk of complications, so combined treatment should be avoided. Lymph node metastasis is a negative prognosis factor in these patients, forcing adjunctive therapy (radiochemotherapy), therefore, intraoperative metastatic node evaluation is crucial to avoid combined treatment. The present communication analyzes a cohort of patients undergoing radical surgery, with special emphasis on the detection of tumor nodes during lymphadenectomy prior to hysterectomy. Of a total of 170 patients undergoing surgery for early-stage Cervical Cancer, 26 patients (14.1%) had lymph node metastasis, 19 (73%) detected during the surgical act (lymphadenectomy) in contemporary biopsy and 7 (27%) in the postoperative period through final histology. In 12 patients, lymph node involvement is obtained through the sentinel lymph node, intraoperative 9 and 3 in final node biopsy reported as negative in contemporary biopsy. The remaining 10 intraoperative diagnoses were made in the contemporary biopsy due to macroscopic suspicion of tumor involvement. In this case series, the contemporary biopsy of the macroscopically suspicious nodes and sentinel lymph nodes, allowed intraoperative detection of 73% of patients with metastatic node, which spared this group of patients from receiving combined treatment with the consequent increase in risk of complications.
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