PT  - JOURNAL ARTICLE
AU  - Minig, Lucas
AU  - Fagotti, Anna
AU  - Scambia, Giovanni
AU  - Salvo, Gloria
AU  - Patrono, María Guadalupe
AU  - Haidopoulos, Dimitrios
AU  - Zapardiel, Ignacio
AU  - Domingo, Santiago
AU  - Sotiropoulou, Maria
AU  - Chisholm, Gary
AU  - Ramirez, Pedro T.
TI  - Incidence of Lymph Node Metastases in Women With Low-Risk Early Cervical Cancer (<2 cm) Without Lymph-Vascular Invasion
AID  - 10.1097/IGC.0000000000001236
DP  - 2018 May 01
TA  - International Journal of Gynecologic Cancer
PG  - 788--793
VI  - 28
IP  - 4
4099  - http://ijgc.bmj.com/content/28/4/788.short
4100  - http://ijgc.bmj.com/content/28/4/788.full
SO  - Int J Gynecol Cancer2018 May 01; 28
AB  - Objective To determine the incidence of lymph node metastasis in women with low-risk cervical cancer stage IA2 or IB1 (<2 cm) without lymph-vascular space invasion.Methods A multicenter retrospective study was performed in patients who underwent radical or simple hysterectomy, conization, or trachelectomy plus pelvic lymphadenectomy for cervical cancer between January 2000 and June 2016.Results A total of 271 patients were included in the study. Median age and body mass index were 46 years (range, 23–77 years) and 24 kg/m2 (range, 18–48 kg/m2), respectively. Twenty-two patients had stage IA2 (8.1%), and 249 (91.9%) had stage IB1. The median tumor size was 14 mm (range, 5–20 mm). Tumor grades were 1 (n = 63 [23.2%]), 2 (n = 120 [44.3%]), 3 (n = 63 [23.2%]), and unknown (25 [9.2%]). Median depth stromal invasion was 6 mm (range, 3–20 mm). Histologic subtypes included squamous (n = 171 [63.1%]), adenocarcinoma (n = 92 [33.9%]), and adenosquamous (n = 8 [3.0%]). Overall incidence of lymph node metastasis was 2.9% (n = 8). The incidence of lymph node involvement in G1, G2, and G3 was 0% (0/63), 5% (6/120), and 3.1% (2/63), respectively. No patient with stage IA2 (regardless of grade or histology) or G1 cervical cancer less than 2 cm (stage IB1) had lymph node metastasis.Conclusions Patients with stage IA2 or IB1 (G1) with tumor size of less than 2 cm and no lymph-vascular space invasion may not need lymph node evaluation. On the other hand, 95% and 98% of patients with grade 2 or 3 tumors, respectively, could potentially undergo an unnecessary lymphadenectomy. Further studies with bigger sample size are required to confirm these results.