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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pelvic lymph nodes from 80 patients with primary invasive cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were evaluated morphologically. Six to 25 (mean 14) lymph nodes from each patient were examined histologically and classified as follows: lymphocyte preominant, germinal center predominant, unstimulated, or lymphocyte depleted. Tumors were classified according to their primary cell type: large cell non-keratinizing, keratinizing squamous cell, small cell, and adenocarcinoma. There was no direct relationship between lymph node morphology and patient age, lesion size, or tumor cell type. A lymphocyte predominant nodal pattern was associated with a statistically significant decrease in lymph node metastases, and tumor recurrence, and an increase in patient survival. In contrast, patients with a lymphocyte depleted nodal pattern had a high incidence of metastatic disease and tumor recurrence, and a decreased survival. Patients with lymph nodes showing an unstimulated or germinal center predominant pattern had an intermediate incidence of nodal metastases and tumor recurrence. These findings suggest that regional lymph nodal morphology may be of prognostic significance in patients with invasive carcinoma of the uterine cervix.
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PMID:The prognostic significance of pelvic lymph node morphology in carcinoma of the uterine cervix. 87 61

There has been concern that invasive cervical carcinoma is more aggressive in young women. We studied retrospectively 36 patients who were less than 35 years old (mean age 30.8 years, range 22-35 years, SD 3.6), and 36 controls (mean age 59.4 years, range 40-72 years, SD 9.5), treated for invasive cervical carcinoma between 1976 and 1986. Histologically 31 (86%) were squamous cell carcinomas and 5 (14%) were adenocarcinomas both in the patients aged 35 years or younger and in the control group. Clinical findings and rates of pelvic lymph nodes metastases were comparable in both groups. Compared to controls, patients aged 35 or younger had longer intervals from diagnosis to recurrence (20.3 months vs. 9.0 months), longer intervals from recurrence to death (15.3 months vs. 7.0 months), and longer intervals from diagnosis to death (39.6 months vs 20.0 months). There was no difference between the groups in the 5-year survival (75% vs. 81%). In conclusion, we found no evidence that the overall clinical behaviour of invasive cervical cancer is more aggressive in young women.
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PMID:Invasive cervical carcinoma in patients aged 35 or younger. 147 29

This study includes 15 patients with invasive cervical cancer found at the time of standard hysterectomy for benign conditions. All patients underwent laparotomy and were subjected to peritoneal cytology, radical parametriectomy, bilateral pelvic and para-aortic lymphadenectomy. Residual disease was found in 10 of the 15 patients (66.7%). The 3-year survival of patients with and without residual disease were 80% and 100%, respectively. Following secondary radical surgery, five patients without evidence of residual disease were identified and spared the risks of radiation therapy. Furthermore, two patients with para-aortic lymph node metastases, who would otherwise have been overlooked, were thus treated completely. One patient died of complications of secondary surgical procedure.
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PMID:Management of invasive cervical cancer in patients initially treated by simple hysterectomy. 158 10

One hundred and seventy patients with invasive cervical cancer up to age 30 were treated and observed from 1970 to 1989. Twenty seven were in stage Ia, 81 in stage Ib, 38 in stage II, 20 in stage III and 4 in stage IV. The cases with poorly differentiated histological types predominated. Sixteen women were gravid at the moment of discovering the cervical carcinoma. Six patients were treated by conisation, total hysterectomy was used in 11 cases. Wertheim-Meigs' operation in 27 cases, Wertheim-Meigs' operation and postoperative radiation in 105 cases and intracavitary radium with external radiotherapy in 14 cases. Seven women were treated conservatively. Five, ten and fifteen year survival rates are 62%, 45% and 45%. Patients with stage I and without lymphogenic metastases have the highest survival rates. The young women with stage Ia and Ib have optimistic prognoses.
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PMID:Invasive cervical carcinoma in women up to age 30. 205 29

This study includes 278 cases of stage I and II cervical cancer subjected to radical hysterectomy and lymphadenectomy. The clinical experience of 278 cases is reviewed. Of these cases, 215 were in stage I, and 63 were in stage II. Intraoperative complications occurred at a rate of 9.7% and involved injuries to the great vessels, lower urinary tract, nerves, and rectum. Operative mortality was found to be 0.3%. Postoperative complications were observed in 20.1% of patients. Fistulae were observed in 8 (2.8%) patients. The overall survival rate was 83.8%. The 5-year survival rates for stages IA, IB, IIA, and IIB were 100.0%, 87.9%, 71.0%, and 64.0%, respectively. Pelvic lymph node metastases varied from 0% for stage IA to 40.0% for stage IIB and paraaortic involvement varied from 0% for stage IA to 50.0% for stage IIB. Radical surgery seems to be the treatment of choice for patients with early invasive cervical cancer.
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PMID:Radical hysterectomy with lymphadenectomy for treatment of early stage cervical cancer: clinical experience of 278 cases. 207 1

Incidence and survival rates were estimated for all white and black women in metropolitan Atlanta with a new diagnosis of in situ or invasive cervical carcinoma between 1975 and 1986. During this period, the average annual age-adjusted incidence (per 100,000) of in situ lesions declined from 51.4 to 25.6 among whites and from 102.2 to 34.6 among blacks. The average annual age-adjusted incidence rate of invasive cervical cancer decreased from 11.8 to 8.2 for whites and from 33.0 to 26.7 for blacks. Although the black-to-white ratio of carcinoma in situ incidence rates declined progressively over time, the excess of invasive cancer among blacks did not decrease. The five-year cumulative survival percentages by stage for whites and blacks, respectively, were 99.1 and 99.1 for in situ carcinoma, 92.2 and 80.5 for locally invasive carcinoma, 49.2 and 40.5 for regionally invasive carcinoma and 3.1 and 3.4 for cases with distant metastases. No improvements in stage at diagnosis of invasive cancer or stage-specific survival rates were observed during this period.
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PMID:Recent trends in the epidemiology of cervical neoplasia. 275 Apr 36

HECD-1 monoclonal antibody has been used to localize E-cadherin, a calcium-dependent cell-cell adhesion molecule, in microwave-treated, paraffin-embedded sections from 53 cases of cervical intraepithelial neoplasia (CIN) (11 CIN I, 22 CIN II, and 20 CIN III), 16 invasive cervical squamous cell carcinomas, and seven metastases. In normal cervix, E-cadherin was expressed on the cell membrane of basal and parabasal cells. Cytoplasmic staining was present in occasional basal cells only. In CIN, the presence and localization of cytoplasmic E-cadherin were found to be significantly correlated with the grade of the CIN lesion. In squamous cell carcinomas, reduced membranous and increased cytoplasmic staining was seen with worsening differentiation. Loss of membranous E-cadherin expression was also detected in 4/7 metastatic deposits. E-cadherin expression (120 kD form on Western blotting) was seen in human cervical carcinoma cell lines (HT3, ME180, C4I, Caski) that maintained the ability to aggregate in a homotypic adhesion assay and showed a typical epithelial morphology. E-cadherin-negative cell lines (Hela, SiHa, C33A) did not show adhesion. HOG-1 was the only E-cadherin-negative cell line which showed a significant degree of cell-cell aggregation. These data indicate that loss of membranous E-cadherin expression may represent one of the abnormalities underlying loss of cell polarity and differentiation which characterize CIN and invasive cervical cancer.
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PMID:Altered expression and function of E-cadherin in cervical intraepithelial neoplasia and invasive squamous cell carcinoma. 763 25

Morbidity and prognostic factors were reviewed in 145 patients who underwent radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer between January 1976 and December 1986. Ninety five patients received adjuvant postoperative external radiotherapy (average 4800 cGY). One hundred twenty patients were F.I.G.O. stage IB, and 25 were clinical stage IIA. Indications for adjuvant radiotherapy included 3 categories of patients with high risk factors: 1) pelvic lymph node metastases, 2) parametrial invasion and/or surgical margins involvement, 3) large volume, deep stromal penetration or uterine extension. Four percent of the patients suffered major gastrointestinal complications, 8.9% had major genito-urinary complications, 19 patients had lymphocytes and 2 patients complained of thromboembolic episodes. Of the 19 patients with major gastrointestinal or genito-urinary morbidity, 7 (38.8%) were related to radiotherapy. Thirty-nine patients had node involvement, 38 of these patients received radiotherapy and 5-year survival rate was 43.5% versus 87.7% in other cases (p < 0.001). Of the 14 patients with parametrial invasion and/or surgical margins involvement, 10 received radiotherapy and overall 5-yrs survival was 85.8%. Of the 37 patients related to third category of risk, 18 received adjuvant radiotherapy with 83.3% 5-yrs survival versus 94.7% of other 19 cases (n.s.). Patients treated with surgery alone had a better 5-yrs survival (96%) than those who received combination therapy (66.3%) (p < 0.001). Adjuvant radiotherapy increases the morbidity of radical hysterectomy, while it has a relative value in preventing local and distant recurrences. In view of reduced survival in high risk patients with node involvement, consideration should be given to adjuvant systemic chemotherapy in high risk cases.
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PMID:Adjunctive radiotherapy after radical hysterectomy in high risk early stage cervical carcinoma. Assessment of morbidity and recurrences. 800 43

From November 1983 to October 1992, 22 patients with invasive cervical cancer stage IB through stage IIIB with metastasis to para-aortic nodes were entered in this study. Five patients were excluded. Of 17 remaining evaluable patients, 5 (29%) were stage IB, 6 (35%) were stage IIB, and 6 (35%) were stage IIIB. Four (24%) had grade 1, 5 (29%) had grade 2, and 8 (47%) had grade 3 tumor. Lymph node metastases were microscopic in 8 (47%) and macroscopic in 9 (53%) patients. All patients received 2 courses of chemotherapy concomitant with radiation as a sensitizer. They were randomized to receive either cisplatin (regimen A) or combination of cisplatin with 5-FU infusion (regimen B). This was followed by maintenance chemotherapy with cisplatin for a maximum of 10 additional courses. Of 17 patients, 7 (41%) received 4-6 courses, 4 (24%) received 6-8 courses, and 6 (35%) received 8-10 courses of maintenance chemotherapy. For extended-field radiation, a panhandle technique was used. External radiation therapy was delivered via 10 or 18 MeV linear accelerator photons, followed by 1 or 2 intracavitary cesium applications. Patients were followed up 8-103 months (median 21 months). Progression-free interval (PFI) for all patients was 5-103 months (median 18 months). Patients with microscopic metastasis to para-aortic nodes had median PFI of 26.5 months compared to 14 months in those with macroscopic nodal metastasis. Seven of 17 patients (41%) are alive from 17 to 103 months with median survival of 32 months. Overall survival for the entire group was 8-103 months (median 21 months). Median survival for patients with microscopic and macroscopic nodal metastasis was 30 and 21 months, respectively. Two- and five-year survival for the entire group was 35 and 12%, respectively. The survival with microscopic metastasis to para-aortic nodes was 50 and 12% compared to survival of 22% at 2 years and 11% at 5 years respectively in those with macroscopic nodal metastasis. There was no significant difference between regimen A and B for local disease control. Maintenance chemotherapy with cisplatin did not appear to significantly improve the 5-year survival. Distant metastases were the predominant sites of failure.
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PMID:Chemotherapy and extended-field radiation therapy to para-aortic area in patients with histologically proven metastatic cervical cancer to para-aortic nodes: a phase II pilot study. 815 90

Accurate staging of invasive cervical cancer is essential to its adequate treatment. Current clinical staging of cervical cancer is inaccurate, particularly for lymph-nodes evaluation. At reduced cost and risks laparoscopic pelvic lymphadenectomy allows accurate detection of lymph-node metastases. Its place in the staging of early cervical cancer is being evaluated. Our inquiry, multicentric and including more than 500 laparoscopic pelvic lymphadenectomies, leads to the conclusion that this technique is accurate and is associated with a reduced but variable morbidity depending on the technique and operator's ability. The implications of the results of laparoscopic lymphadenectomy in the type and modalities of subsequent treatment are discussed.
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PMID:[Pelvic endoscopic lymphadenectomy in the assessment of early cancer of the uterine neck: survey of 25 French hospital centers]. 836 31


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