Parametrial involvement in early stage cervical cancer patients with tumor less 2 cm: The myth or reality?

Czech version

Authors: Jaroslav Klát; L. Ševčík
Authors‘ workplace: Porodnicko-gynekologická klinika, FN Ostrava, přednosta MUDr. O. Šimetka
Published in: Ceska Gynekol 2010; 75(6): 556-559

Overview

Objective:
The aim is review of studies exploring the relationship of parametrial involvement with other tumor-related factors (lymphovascular space invasion, depth of stromal invasion, status of sentinel lymph node) in early stage cervical cancer patients with tumor less than 2 cm.

Design:
Review.

Settings:
Department of Obstetrics and Gynaecology, University Hospital Ostrava.

Methods:
Searching of the literature in database PubMed by combination of the key words: early stage, cervical cancer, parametrial involvement, parametrectomy.

Conclusion:
Based on literature review, the metastatic parametrial involvement in early-stage cervical cancer patients with tumor less than 2 cm and with other tumor-related factors is very rare. Before omitting of parametrectomy in these low-risk patients, these encouraging data must be confirmed in the prospective multicentric trials.

Key words:
cervical cancer, parametrectomy, radical surgery, sentinel lymph node, parametrial involvement.

Sources

1. Benedetti-Panici, P., Maneschi, F., D’Andrea, G., et al. Early cervical carcinoma. The natural history of lymph node involvement redefined on the basis of thorough parametrectomy and giant section study. Cancer, 2000, 88, p. 2267-2274.

2. Bergmark, K., Avall-Lundquist, E., Dickman, PW., et al. Vaginal changes and sexuality in women with a history of cervical cancer. N Eng J Med, 1999, 340, p. 1383-1389.

3. Castellsagué, X., de Sanjosé, S., Aguado, T., et al. HPV and Cervical Cancer in the World. 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Dostupný z www.who.int/hpvcentre

4. Coutant, C., Cordier, AG., Guillo, E., et al. Clues pointing to simple hysterectomy to treat early-stage cervical cancer. Oncol Rep, 2009, 22, p. 927-934.

5. Covens, A., Rosen, B., Murény, J., et al. How important is removal of the parametrium at surgery for carcinoma of the cervix? Gynecol Oncol, 2002, 84, p. 145-149.

6. Fader, AN., Edwards, RP., Cost, M., et al. Sentinel lymph node biopsy in early-stage cervical cancer: utility of intraoperative versus postoperative assessment. Gynecol Oncol, 2008, 111, p. 13-17.

7. Frumovitz, M., Sun, CC., Schmeler, KM., et al. Parametrial involvement in radical hysterectomy specimen for women with early-stage cervical cancer. Obstet Gynecol, 2009, 114, p. 93-99.

8. Kinney, WK., Hodge, DO., Egorshin, EV, et al. Identification of a low-risk subset of patients with stage IB invasive squamous cancer of the cervix possibly suited to less radical surgical treatment. Gynecol Oncol, 1995, 57, p. 3-6.

9. Lousquy, R., Delpech, Y., Barranger, E. Response to M. Pluta: Less radical surgery than radical hysterectomy in early stage cervical cancer-a pilot study. Gynecol Oncol, 2010, 117, p. 147-148.

10. Magrina, JF., Goodrich, MA., Weaver, AL., Podraz, KC. Modified radical hysterectomy: morbidity and mortality. Gynecol Oncol., 1995, 59, p. 277-282.

11. Pluta, M., Rob, L., Charvat, M., et al. Less radical surgery than radical hysterectomy in early stage cervical cancer. A pilot study. Gynecol Oncol, 2009, 113, p. 181-184.

12. Puente, R., Guzman, S., Izrael, E., Poblete, MT. Do the pelvic lymph nodes predict the parametrial status in cervical cancer stages IB-IIA? Int J Gynecol Cancer, 2004, 14, p. 832-840.

13. Ralph, G., Winter, R., Michelitsch, L., Tamussino K. Radicality of parametrial resection and dysfunction of the urinary tract after radical hysterectomy. Eur J Gyneacol Oncol, 1991, 12, p. 27-30.

14. Raspagliesi, F., Ditto, A., Fontanelou, R., et al. Type II versus type III nerve-sparing radical hysterectomy: comparison of urinary tract dysfunction. Gynecol Oncol, 2006, 102, p. 256-262.

15. Rob, L., Halaska, M., Robova, H. Nerve-sparing and individually tailored surgery for cervical cancer. Lancet Oncol, 2010, 11, p. 292-301.

16. Silva-Filho, AL., Reis, FM., Traiman, P., et al. Clinicopathological features influencing pelvic lymph node metastasis and vaginal and parametrial involvement in patients with carcinoma of the cervix. Gynecol Obstet Invest, 2005, 59, 9, p. 92-96.

17. Stageman, M., Louwen, M., vad der Velden, J., et al. The incidence of parametrial tumor involvement in select patients with early cervix cancer is too low to justify parametrectomy. Gynecol Oncol, 2007, 105, p. 475-480.

18. Steed, H., Capstick, V., Schepansky, A., et al. Early cervical cancer and parametrial involvement: Is it significant? Gynecol Oncol, 103, 2006, p. 53-57.

19. Strnad, P., Robova, H., Skapa, P., et al. A prospective study of sentinel lymph node status and parametrial involvement in patient with small tumour volume cervical cancer. Gynecol Oncol, 2008, 109, p. 280-284.

20. Van Meurs, H., Visser, O., Buist MR., et al. Frequency of pelvic lymph node metastases and parametrial involvement in stage IA2 cervical cancor: a population-based study and literature review. Int J Gynecol Cancer, 2009, 19, p. 21-26.

22. Winter, R., Haas, J., Reich, O., et al. Parametrial spread of cervical cancer in patients with negative pelvic lymph node. Gynecol Oncol, 2002,84, p. 252-257.

23. Wright, JD., Grigsby, PW., Brooks, R., et al. Utility of parametrectomy for cancer treated with radical early stage cervical hysterectomy. Cancer, 2007, 110, p. 1281-1286.