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468 Pelvic and paraaortal lymphatic metastases in cervical adenocarcinoma and squamous cell cervical carcinoma II FIGO stage – a single-center clinical study
  1. Stefan Kovachev1,
  2. Anita Ganovska1,
  3. Stelyana Gitsova1 and
  4. Miladin Kovachev2
  1. 1Gynecology, Military Medical Academy, Sofia, Sofia, Bulgaria
  2. 2Medical University, Sofia, Sofia, Bulgaria


Introduction/Background One of the main pathway for metastasis of cervical cancer, including in the first and second (FIGO) stages is lymphatic. Adenocarcinoma of the cervix is much rarer than the squamous cell histological species.

Methodology A retrospective database analysis involving 65 patients with cervical II FIGO stage carcinoma for a 5-year period from 2020 to 2023 was performed. All patients have undergone surgery (radical type C hysterectomy) and pelvic and paraaortic lymph node dissection. Various factors were analyzed for the purpose of the study

Results From all 65 (100%) patients included, 43 (66.2%) have squamous cell carcinoma and 22 (33.8%) adenocarcinoma. In 21 (32%) out of 65 patients, lymph metastases were found, at 4 (6.2%) of them pelvic and paraaortic. It has been demonstrated that metastasis of cervical cancer in the right lymph chains are more frequent. The average number of metastases, regardless of their location, is equal to or greater than 2. Moderately differentiated cervical carcinomas metastasize most commonly. More frequent are lymph metastases in squamous cell carcinoma - 15 (23.1%) patients compared to only 6 (9.2%) with adenocarcinoma. The most frequent are metastases in Stage 2B under the TNM classification. Following changes in 2018, in the presence of metastases in the lymph nodes, the stage of FIGO’s disease is directly defined as IIIC1 in pelvic lymphatic metastases and IIIC2 in para-aortic lymphatic metastases.

Conclusion Our study confirms the claim that cervical carcinoma metastasizes in the pelvic lymph nodes before it reaches para-aortic. Better understanding of how cancer metastasis developed can help to improve the overall survival of patients.

Disclosures Authors declare no conflict of interest.

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