UICC World Cancer Congress 2006

Objective:Metastatic disease in pelvic lymph nodes is the strongest prognostic factor in carcinomas of the uterine cervix (CX). Contrary to breast cancer nothing is known about the prognostic impact of micrometasases (i.e. metastatic deposits < 0.2cm = pN1mic). Methods: Pelvic lymph nodes of 266 surgically treated CX FIGO-stage IB to IIB were re-examined histologically with detailed measurement of metastatic deposits in pelvic nodes using ocular micrometer. Recurrence free and overall survival was correlated to pelvic lymph node status (pN0 vs. pN1mic vs. pN1 = metastasis > 0.2cm).

Results: 29.7% of all patients represented with pelvic lymph node involvement. 22.1% of these patients showed micrometastases (pN1mic). Patients with macrometasases (pN1) and those with micrometastatic disease (pN1mic) represented significant reduced recurrence free survival time (112.6+6.8 and 122.5+9.6 months), when compared to patients with metastatic disease (pN0: 190.9+3.0 months; p<0.0001). The 5-year-overall survival was decreased in patients with metastatic disease (pN0: 86.6%, pN1mic: 63.8%, pN1: 48.2%; p<0.0001).