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首页> 外文期刊>International journal of gynecological cancer: official journal of the International Gynecological Cancer Society >Pretreatment retroperitoneal para-aortic lymph node staging in advanced cervical cancer: A review
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Pretreatment retroperitoneal para-aortic lymph node staging in advanced cervical cancer: A review

机译：晚期宫颈癌的腹膜后腹主动脉旁淋巴结分期术前评价

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Objective: The aims of this study were to evaluate the safety and impact of pretreatment surgical para-aortic lymph node staging (PALNS) in advanced cervical cancer (International Federation of Gynecology and Obstetrics stage IB2-IVA) and to evaluate the preoperative imaging of PALNs. Methods: We searched in PubMed and the Cochrane Library to identify data investigating the role of surgical PALNS. Selection criteria included English-language and advanced-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IB2-IVA) articles. Results: Twenty-two articles were included. Para-aortic lymph node metastases were present in 18% (range, 8%Y42%) of all patients with cervical cancer stage IB to IVA. The proportions of positive para-aortic nodes on histological analysis with suspicious para-aortic nodes on imaging (positive predictive value) were 20% to 66%, 0% to 27%, 86% to 100%, and 50% to 75% for computed tomographic (CT) scan, magnetic resonance imaging (MRI) scan, positron emission tomography (PET), and PET-CT, respectively. The negative predictive values of the imaging techniques were 53% to 92% for CT scan, 75% to 91% for MRI, 87% to 94% for PET, and 83% to 92% for PET-CT. The proportions of histologically proven PALN metastasis with normal findings on imaging were 9% to 35% for CT scan and MRI, 4% to 11% for PET, and 6% to 15% for PET-CT. The mean complication rate of PALNS is 9%, with a range of 4% to 24%, with lymphocysts being the most common complication. Conclusions: Pretreatment surgical PALN dissection or sampling is feasible, with low complication rates and short delay in starting treatment. Pretreatment PET or PET-CT is the most accurate imaging method in detecting PALN metastases but has limitations detecting microscopic tumor volumes. Even with normal findings on PET-CT, PALN metastases are present in 4% to 15% of patients. Positive PALNs in stage IB2 to IVA cervical cancer will lead to modification of treatment and may lead to better overall and disease-free survival.
机译：目的：本研究的目的是评估晚期宫颈癌（国际妇产科联合会IB2-IVA期）的手术前主动脉旁淋巴结分期（PALNS）的安全性和影响，并评估PALN的术前影像。方法：我们在PubMed和Cochrane库中进行搜索，以识别调查外科PALNS作用的数据。选择标准包括英语和晚期宫颈癌（国际妇产科联合会IB2-IVA期）文章。结果：纳入22篇文章。在所有宫颈癌IB至IVA期患者中，主动脉旁淋巴结转移存在于18％（范围为8％Y42％）。组织学分析中阳性主动脉旁淋巴结与影像学上可疑的主动脉旁淋巴结的比例（阳性预测值）分别为20％至66％，0％至27％，86％至100％和50％至75％计算机断层扫描（CT）扫描，磁共振成像（MRI）扫描，正电子发射断层扫描（PET）和PET-CT。成像技术的阴性预测值为CT扫描为53％至92％，MRI为75％至91％，PET为87％至94％，PET-CT为83％至92％。经组织学证实为PALN转移且影像学正常的比例在CT扫描和MRI中为9％至35％，PET为4％至11％，PET-CT为6％至15％。 PALNS的平均并发症发生率为9％，范围为4％至24％，其中淋巴囊肿是最常见的并发症。结论：术前PALN解剖或取样是可行的，并发症发生率低，开始治疗的延迟时间短。预处理PET或PET-CT是检测PALN转移的最准确的成像方法，但在检测微观肿瘤体积方面存在局限性。即使PET-CT表现正常，PALN转移仍存在于4％至15％的患者中。 IB2期至IVA宫颈癌的PALN阳性将导致治疗方法的改变，并可能导致更好的总体生存率和无病生存期。

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