Tertiary prevention strategies for micrometastatic lymph node cervical cancer: A systematic review and a prototype of an adapted model of care. in Critical reviews in oncology/hematology / Crit Rev Oncol Hematol. 2024 May;197:104329. doi: 10.1016/j.critrevonc.2024.104329. Epub 2024 Mar 26
2024
ASL Cuneo 2
Tipo pubblicazione
Systematic Review
Autori/Collaboratori (24)Vedi tutti...
?niadecki M
Department of Gynaecology and Obstetrics, Medical University of Gda?sk, Gda?sk, Poland. Electronic address: marcinsniadecki@gumed.edu.pl.
Guani B
Hospital of Fribourg HFR, Chemin des Pensionnats 2/6, Villars-sur-Glâne 1752, Switzerland.
Jaworek P
Department of Gynaecology and Obstetrics, Medical University of Gda?sk, Gda?sk, Poland.
et alii...
Abstract
PURPOSE: We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases. METHODOLOGY: We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases. The electronic databases for literature and relevant articles were analysed. RESULTS: Fifteen studies, (4882 patients), were included in our systematic review. While the results show that MICs significantly worsen prognosis in early CC. A tertiary prevention algorithm for low volume lymph node disease may stratify follow-up according to the burden of nodal disease and provide data that helps improve follow-up performance. CONCLUSION: MICs worsen prognosis and should be managed as suggested by the algorithm. However, this algorithm must be externally validated. The clinical impact of isolated tumor cells (ITC) remains unclear.
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PMID : 38527594
DOI : 10.1016/j.critrevonc.2024.104329
Keywords
Female; Humans; Lymph Nodes/pathology; Lymphatic Metastasis; Neoplasm Micrometastasis/pathology; Neoplasm Recurrence, Local/prevention & control/pathology; Prognosis; Tertiary Prevention/methods; Uterine Cervical Neoplasms/pathology/diagnosis/prevention & control; Algorithm; Cervical cancer; Micrometastasis; Prevention; Review; Sentinel lymph node;