Metastasis Detection and Clinical Significance According to Localization of Resecting Lymph Nodes in Female Reproductive System Cancers

Arslan R., Ergül B.

Journal of Gynecology and Womens Health, cilt.25, ss.1-5, 2023 (Scopus)

Özet

Introduction and Aim: Female reproductive system cancers (FRSC) are a major cause of morbidity and mortality all over the world, and especially cervical cancers are the 4th most common cancer after breast, lung and colorectal cancers. Ovarian and endometrial cancers have increased in recent years. Regional lymphadenectomy is frequently used during the initial surgery in the treatment of these tumors. Detection of metastases in resected lymph nodes constitutes an important histopathological and clinical prognostic parameter. In our study, it was aimed to investigate the detection of metastases according to localization in resected lymph nodes in FRSC cancers and to investigate its clinical significance.

Methods: In our study, pathological reports including female reproductive system cancers diagnosed at Atatürk University Faculty of Medicine, Pathology Department between January 1, 2010 and November 30, 2021 were retrospectively scanned. The age, organ, tumor type, localization of the resected lymph nodes and metastasis rates in these localizations were determined and compared with the literature.

Results: In our study, 152 materials made due to FRSC were evaluated. The mean age of the cases was 56.86, and 87 (57%) of them were localized to the ovary, 58 (38%) of them to the uterus, and 7 (5%) of them to the cervix. Lymph node dissection was performed in 128 (84%) patients with tumor, and not to 24 (16%). In terms of tumor type, serous carcinoma was the first line and endometrioid carcinoma was second line. Metastasis rates were found to be 25% in the resected right pelvic lymph nodes and 23.7% in the left pelvic lymph nodes. Metastasis was detected in 35% of the paraaortic lymph nodes, and the rate was found to be higher.

Conclusion: In our study, regardless of type, it was observed that right and left pelvic node positivity was similar, and paraaortic lymph node metastasis was higher than the others. In assesments based on tumor subtypes, It is important to observe a higher rate of paraaortic and pelvic lymph node involvement in serous carcinomas in terms of guiding the treatment