کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3945265 1254256 2012 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Pattern analysis of regional spread and therapeutic lymph node dissection in cervical cancer based on ontogenetic anatomy
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
پیش نمایش صفحه اول مقاله
Pattern analysis of regional spread and therapeutic lymph node dissection in cervical cancer based on ontogenetic anatomy
چکیده انگلیسی

ObjectiveIn cervical cancer lymph node dissection is applied for regional tumor staging. Up to now, the use of (chemo)radiation in the nodal positive patient has prevented the exact pattern analysis of regional tumor spread and the evaluation of the therapeutic role of lymph node dissection. New surgical techniques founded on ontogenetic instead of functional anatomy for the treatment of cervical cancer dispensing with adjuvant radiotherapy offer the possibility to accurately determine the topography of regional lymph node metastases which is the prerequisite for optimized diagnostic and therapeutic lymph node dissection.MethodsPatients with cervical cancer FIGO stages IB–IIB were treated with total mesometrial resection (TMMR) and lymph node dissection after exposing the ontogenetic visceroparietal compartments of the female pelvis. Resected lymph nodes were allocated to regions topographically defined by the embryonic development of the iliac, lumbar and mesenteric lymph systems prior to histopathological assessment.Results71 of 305 treated patients had lymph node metastases. Topographic distribution of these metastases at primary surgery and analysis of pelvic failures showed a spatial pattern related to the ontogenesis of the abdominopelvic lymphatic system. Five-year locoregional tumor control probability was 96% (95% CI: 94–98) for the whole group and 87% (95% CI: 77–97) for nodal positive patients.ConclusionsThe pattern of regional spread in cervical cancer can be comprehended and predicted from ontogenetic lymphatic compartments. In patients with early cervical cancer lymph node dissection based on ontogenetic anatomy achieves high regional tumor control without adjuvant radiation.


► The pattern of lymph node metastases can be comprehended from the development of the lymphatic system.
► Therapeutic lymph node dissection based on ontogenetic anatomy allows dispensing with adjuvant radiotherapy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gynecologic Oncology - Volume 125, Issue 1, April 2012, Pages 168–174
نویسندگان
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