title: Prevalence of lymph nodes in the parametrium of radical vaginal trachelectomy (RVT) specimen.
abstract: OBJECTIVE
  In order to evaluate radicality in fertility preserving surgery in women with early invasive cervical cancer we analyzed the parametrium of specimens of patients treated by radical vaginal trachelectomy for the presence of lymph nodes. We tried to identify morphologic factors associated with the presence of parametrial lymph nodes.
  
  
  METHODS
  We analyzed surgical specimens of 112 patients who underwent radical trachelectomy between June 2004 and April 2009 at the Department of Gynecologic Oncology at Charité Campus Benjamin Franklin and Campus Mitte. All parametrial tissue was step sectioned and a total of 1878H&E stained histological sections were analyzed.
  
  
  RESULTS
  In 8 patients (7.1%) a total of 13 lymph nodes were detected. Five lymph nodes in four patients had been primarily detected by routine histological examination. In one of these patients (0.9%) a 2mm lymph node metastasis was found. Serial sectioning revealed additional seven lymph nodes in four patients. The thickness of parametrium correlated significantly with the presence of lymph nodes in the parametrium.
  
  
  CONCLUSIONS
  The presence of small lymph nodes in the parametrium of specimens of radical trachelectomy is low. In patients with early-stage cervical cancer, the incidence of metastasis is less than 1%. Preoperative assessment of the volume of the parametrium may indicate which patients need parametrial resection.
authors.affiliation: Department of Gynecology, Charité Universitätsmedizin, Berlin, Germany. malgorzata.lanowska@charite.de
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Lanowska
authors.forename: Lars
authors.initials: L
authors.lastname: Morawietz
authors.forename: Arne
authors.initials: A
authors.lastname: Sikora
authors.forename: Gert
authors.initials: G
authors.lastname: Räber
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.forename: Dorothee
authors.initials: D
authors.lastname: Speiser
authors.forename: Kati
authors.initials: K
authors.lastname: Hasenbein
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000328:Adult; D001956:Broad Ligament / Q000473:pathology*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*