Possibilities and limits of modern metods of diagnosis of distant metastases locallyadvanced cervical cancer

Abstract

A retrospective study of 245 cases of recurrent cervical cancer, in every third case was detected metastases in paraaortic lymph nodes. Given these results, a prospective study aimed at optimizing the staging of cervical cancer Ib1–IIIb stages. Analyzed 48 clinical cases of patients with locally - common forms of cervical cancer, which before the combined treatment paraaortic lymphadenectomy was performed through laparoscopy with subsequent histological examination of surgical specimens. At the preoperative stage, to identify distant metastasis in para-aortic lymph nodes, patients were examined by various methods of radiation diagnosis. The sensitivity of MRI was 75 %, specificity 79 %, sensitivity and specificity of ultrasonography – 75 % and 93 %, respectively. The positive predictive value of the test was 25 % MRI, ultrasound – 50 %. Performing paraaortic lymphadenectomy with the greatest possible to individualize treatment policy and, as a consequence, to improve the results of combined treatment of patients with locally-common forms of cervical cancer. The use of laparoscopic approach, given the short period of rehabilitation, has not led to the postponement of chemoradiotherapy.

Keywords

cervical cancer / para-aortic lymphadenectomy / lymphadenectomy / laparoscopy / combined therapy / radiology

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Kargopolova M.V., Maksimov S.Y., Berlev I.V., Khadzhimba A.S., Chepik O.F., Novikov S.N., Gershfeld E.D., Vyshinskaya Y.A.