title: Lymph node micrometastases in initial stage cervical cancer and tumoral recurrence.
abstract: OBJECTIVE
  To evaluate the prevalence of micrometastases in lymph node tissue of patients with stage Ib1-IIA cervical cancer, the correlation of micrometastases with tumor recurrence and survival, and the expression of D2-40 in the primary tumor of patients with recurrence and/or micrometastases and its correlation with histopathologic findings.
  
  
  METHODS
  In a retrospective study, the medical records of all patients with cervical cancer treated at a hospital in São Paulo, Brazil, between 2001 and 2007 were reviewed. Patients with no lymph node metastases and treated with radical hysterectomy without adjuvant treatment were included. Tumor sections were reviewed and lymph nodes were analyzed with AE1/AE3. Patients with and without recurrence were compared. The presence of lymph node micrometastasis or isolated tumor cells was also evaluated.
  
  
  RESULTS
  Of the 83 patients evaluated, 15 (18%) had recurrence. Significant differences between patients with and without recurrence were observed with regard to tumor greatest axis, clinical stage, number of micrometastases, and negative lymph nodes (P≤0.04). Lymph node micrometastases and isolated tumor cells were significantly different for a stromal invasion depth greater than 2/3 (P=0.046).
  
  
  CONCLUSIONS
  The presence of lymph node micrometastases is an important risk factor for tumor recurrence. These patients should be considered eligible for adjuvant radiochemotherapy treatment.
authors: Gynecology and Obstetrics Department, Faculdade de Medicina de São José do Rio Preto, Hospital de Base, São José do Rio Preto, Brazil. Electronic address: leandrocolturato@gmail.com.
authors: Leandro F
authors: LF
authors: Colturato
authors: Surgical Oncology Department, Centro de Referência da Saúde da Mulher do Estado de São Paulo, Hospital Pérola Byington, São Paulo, Brazil.
authors: Roney C
authors: RC
authors: Signorini Filho
authors: Pathology Department, Centro de Referência da Saúde da Mulher do Estado de São Paulo, Hospital Pérola Byington, São Paulo, Brazil.
authors: Raquel C M
authors: RC
authors: Fernandes
authors: Centro de Referência da Saúde da Mulher do Estado de São Paulo, Hospital Pérola Byington, São Paulo, Brazil; Universidade Federal de São Paulo, São Paulo, Brazil.
authors: Luiz H
authors: LH
authors: Gebrim
authors: Gynecology and Obstetrics Department, Faculdade de Medicina de São José do Rio Preto, Hospital de Base, São José do Rio Preto, Brazil.
authors: Antônio H
authors: AH
authors: Oliani
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Gynecologic surgical procedures; Keratins; Local; Neoplasm micrometastasis; Neoplasm recurrence; Uterine cervical neoplasms