CHUV, Centre hospitalier universitaire vaudois, Lausanne, Switzerland.
CHU de l'Archet 2, Nice, France.
Int J Gynecol Cancer. 2019 Mar;29(3):447-452. doi: 10.1136/ijgc-2018-000089. Epub 2019 Jan 4.
The aim of this study was to evaluate the impact of micrometastasis and isolated tumor cells on disease recurrence in patients with early-stage cervical cancer.
We included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA1 with lymphvascular space invasion, stage IA2, and IB1 who participated in the SENTICOL1 trial. A centralized histologic analysis with re-reading and ultrastaging was performed 3 months after surgery and treatment was not impacted by findings from our study. Patients were followed for 3 years and outcomes were compared according to prognostic factors.
A total of 139 patients were included and 13 recurrences were found. There were two recurrences in patients with positive sentinel lymph node (SLN) (one macrometastases and one micrometastases) and 11 recurrences in patients with negative lymph nodes (sentinel or non-sentinel). Among patients with positive SLN for micrometastases there was only one recurrence. No patient with isolated tumor cells on their lymph nodes experienced a recurrence. There was a significant decrease in disease-free survival in patients aged >50 years (p = 0.01).
Evidence of micrometastasis or isolated tumor cells in the SLN of untreated patients with early cervical cancer in the SENTICOL1 trial did not impact progression-free survival.
本研究旨在评估早期宫颈癌患者微转移和孤立肿瘤细胞对疾病复发的影响。
我们纳入了参与 SENTICOL1 试验的国际妇产科联合会（FIGO）分期为 IA1 伴血管淋巴管间隙浸润、IA2 和 IB1 的患者。术后 3 个月进行集中的组织学分析、重新读片和超分期，且治疗不受我们研究结果的影响。患者随访 3 年，根据预后因素比较结局。
共纳入 139 例患者，发现 13 例复发。在阳性前哨淋巴结（SLN）的患者中有 2 例复发（1 例为巨转移，1 例为微转移），在阴性淋巴结（前哨或非前哨）的患者中有 11 例复发。在 SLN 微转移阳性的患者中仅有 1 例复发。在淋巴结有孤立肿瘤细胞的患者中无一例复发。年龄>50 岁的患者无疾病生存率显著降低（p=0.01）。
SENTICOL1 试验中，早期宫颈癌未经治疗的患者 SLN 中存在微转移或孤立肿瘤细胞证据并未影响无进展生存率。
