Mesorectal lymph node involvement and prognostic implications at total pelvic exenteration for gynecologic malignancies Journal Article


Authors: Mourton, S. M.; Chi, D. S.; Sonoda, Y.; Alektiar, K. M.; Venkatraman, E. S.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title: Mesorectal lymph node involvement and prognostic implications at total pelvic exenteration for gynecologic malignancies
Abstract: Objectives. To determine the incidence and prognostic implications of positive mesorectal lymph nodes in patients undergoing total pelvic exenteration for recurrent gynecologic malignancies. Methods. We performed a retrospective chart review of all patients who had undergone total pelvic exenteration for a gynecologic malignancy between July 1992 and December 2003. Patient charts were reviewed for information regarding demographics, site of cancer, histology, pathology report, and time to recurrence. Results. Fifty-eight women had undergone total pelvic exenteration for recurrent gynecologic malignancies during the study period and 57 were available for analysis. Primary cancer site was as follows: cervix, 37 (65%); vagina, 8 (14%); vulva, 5 (9%); and uterine corpus, 7 (12%). In 30 patients (53%), the mesorectal lymph node status was pathologically evaluated. Of these 30 patients, 3 (10%) had positive mesorectal lymph nodes at the time of total pelvic exenteration. All 3 patients had rectal wall involvement (rectal submucosa, 2; rectal mucosa, 1), and all 3 patients recurred within 4 months of pelvic exenteration. The median time to recurrence after surgery was 2.4 months in those patients with positive mesorectal lymph nodes compared with 7.3 months in those with negative mesorectal lymph nodes (P = 0.005). When individually adjusted for other prognostic variables, such as margin status, tumor grade, lymphovascular space involvement, primary cancer site, and histologic type, a finding of positive mesorectal lymph nodes was associated with a shorter time to recurrence of disease (all < 0.05). Conclusions. Mesorectal lymph node involvement is a common finding at total pelvic exenteration, particularly in patients with rectal wall involvement. Patients with positive mesorectal lymph nodes appear to have a worse outcome with a shorter time to recurrence of disease. © 2005 Elsevier Inc. All rights reserved.
Keywords: adolescent; adult; controlled study; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; cancer localization; cancer recurrence; conference paper; lymph node metastasis; lymph nodes; lymphatic metastasis; demography; incidence; retrospective study; carcinogenesis; genital neoplasms, female; tumor recurrence; lymph node; gynecologic cancer; uterine cervix carcinoma; vulva carcinoma; rectum; vagina carcinoma; uterus carcinoma; pelvic exenteration; mesorectal lymph nodes
Journal Title: Gynecologic Oncology
Volume: 100
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2006-03-01
Start Page: 533
End Page: 536
Language: English
DOI: 10.1016/j.ygyno.2005.08.039
PUBMED: 16226800
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Venkatraman Ennapadam Seshan
    341 Seshan
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    596 Chi
  4. Kaled M Alektiar
    287 Alektiar
  5. Yukio Sonoda
    370 Sonoda