Cancer Cervix and Pelvic Lymph Nodal Metastasis – Our Experience from A Tertiary Health Care Center in South India
Journal Title: International Journal of Medical and Health Sciences - Year 2013, Vol 2, Issue 4
Abstract
Objective:To analyze the incidence of nodal metastasis in cancer cervix patients clinically and histopathologically. Nodal metastasis was correlated with different parameters like stage, differentiation and extra nodal spread like lymphovascular invasion (LVI) and perivascular invasion (PVI). Materials and Methods: This is a retrospective study conducted in a tertiary health care center in South India. The study period was from January 2008 to May 2012. Lymph node positivity was analyzed in 80 patients who underwent surgery for cancer cervix. Seventy six patients underwent radical hysterectomy and four patients of carcinoma insitu (CIN-III) underwent simple hysterectomy. Results: The mean age of patients was 49.53 ± 10.8 years. The most common symptom was bleeding per vaginum 67(83.8%). CIN-III in four (5%), stage IA in five (6.3%), stage IB in 24(30%), stage IIA in 41(51.2%) and stage IIB in six (7.5%) patients were noted respectively. Histopathologically majority were squamous cell carcinoma (91%). Pelvic lymph nodal metastasis was identified in ten (12.5%) patients. LVI was noted in six patients and three patients had PVI in the tumor tissue. All the parameters were statistically significant. In the follow-up period, eight patients received adjuvant external beam radiotherapy, 24 patients combined external beam and intracavitary radiotherapy and one patient adjuvant chemo radiotherapy. Conclusion: The incidence of lymph nodal metastasis in cancer cervix patients is quite significant. With the limited follow-up available, we are of the opinion that, radical hysterectomy and bilateral pelvic lymphadenectomy is an effective mode of treatment in patient with early stage cancer cervix.
Authors and Affiliations
Amitabh Jena, Rashmi Patnayak, Siva kumar Reddy, B. Manilal, Kausik Hari, A Ramesh
Keywords
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