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Lymph node counts in uterine cancer: a randomized double blind trial
Joseph T Santoso1, Ali Azadi, Jim Wan
1Division Gynecology Oncology, University of Tennessee West Clinic, Memphis, TN 38104, USA. jsantoso@westclinic.com
Gynecologic Oncology
|March 10, 2009
Summary
Sending surgical lymph nodes in four containers, instead of one, significantly increases the number of lymph nodes counted for uterine cancer staging. This method improves accuracy in determining the extent of cancer spread.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
Background:
- Accurate lymph node count is crucial for precise cancer staging.
- Current methods may underestimate the total number of lymph nodes retrieved.
Purpose of the Study:
- To evaluate if dividing pelvic lymph nodes into four containers increases nodal yield compared to a single container.
- To determine the impact on cancer staging accuracy.
Main Methods:
- Prospective study of 104 uterine cancer patients undergoing hysterectomy and lymphadenectomy.
- Pelvic lymph nodes from four specific locations were collected.
- Blinded ex vivo randomization assigned specimens to one or four containers per patient (each patient as own control).
Main Results:
- Patients randomized to four containers showed a higher average lymph node count compared to those randomized to a single container.
- This finding was consistent regardless of the side of the pelvis.
- Statistical significance was observed in both groups (p=0.026 and p=0.042).
Conclusions:
- Submitting surgical lymph nodes in multiple separated specimens enhances nodal count compared to single specimen submission.
- This technique offers a potential improvement for accurate lymph node staging in uterine cancer.
