title: Microscopic evaluation of lymph-node-bearing tissue in early-stage cervical cancer: a dual-institution review.
abstract: OBJECTIVE
  We compared two different methods of microscopic lymph node examination of cervical cancer radical hysterectomy specimens to ascertain which method translates into higher nodal counts and improved detection of nodal metastasis, at M. D. Anderson Cancer Center (MDACC) and the University of North Carolina (UNC).
  
  
  METHODS
  We retrospectively reviewed the records of 155 patients with early-stage cervical cancer who underwent open radical hysterectomy and pelvic lymph node dissection from 2000 to 2006. At MDACC lymph nodes were grossly dissected from submitted adipose tissue surgical specimens and then microscopically examined. At UNC, grossly detected lymph nodes and the remaining adipose tissue were microscopically examined. Data regarding clinicopathologic features and lymph node dissection were available for all patients.
  
  
  RESULTS
  No differences in stage, grade or histology were noted between the two centers. The median age and body mass index were both higher at MDACC (40 versus 36 years of age; 28 versus 26 mg/m(2); P < 0.05) The median lymph node count was lower at MDACC (16 versus 23; P = 0.001). By multivariate analysis, UNC evaluation was associated with higher total lymph node count (P = 0.001). However, no significant difference was noted between institutions in proportion of patients with nodal metastases (MDACC 20.3%; UNC 13.5%; P = 0.47).
  
  
  CONCLUSIONS
  The UNC method of microscopically examining the entire adipose tissue sample may be associated with higher nodal count at open radical hysterectomy. Higher nodal count, however, may not translate into increased identification of nodal metastases.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Louisville Medical Center, Louisville, KY, USA. michael.milam@louisville.edu
authors.forename: Michael R
authors.initials: MR
authors.lastname: Milam
authors.forename: Lisa
authors.initials: L
authors.lastname: Abaid
authors.forename: Ricardo
authors.initials: R
authors.lastname: dos Reis
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Paola A
authors.initials: PA
authors.lastname: Gehrig
authors.forename: Chad
authors.initials: C
authors.lastname: Livasy
authors.forename: Russell R
authors.initials: RR
authors.lastname: Broaddus
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D055815:Young Adult