Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread — Is lymph node assessment only required in patients with LVSI?

Hans H. B. Wenzel*, Kim G. G. Van Kol, Hans W. Nijman, Valery E. P. P. Lemmens, Maaike A. Van der Aa, Renee M. F. Ebisch, Ruud L. M. Bekkers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective. Cervical cancer with 7 mm horizontal spread is classified FIGO IA instead of FIGO IB in the revised staging system, as horizontal spread is no longer considered. We aimed to determine the incidence of lymph node metastasis (LNM) and, consequently, the necessity of pelvic lymph node assessment.

Methods. Patients diagnosed between January 2015 and May 2019 with cervical cancer FIGO (2009) stage IB with 7 mm horizontal spread, were identified from the Netherlands Cancer Registry. Associations between disease-characteristics and lymph node metastasis (LNM), and overall survival, were assessed.

Results. Of 170 patients, six (3.5%) had LNM: 4/53 (7.6%) with adenocarcinoma and 2/117 (1.7%) with squamous cell carcinoma (p = .077). Four-year overall survival was 98.2%. LNM was observed more often in tumours with LVSI (4/43 patients, 9.3%) than without LVSI (2/117 patients. 1.7%) (p .045). In adenocarcinoma with 3-5 mm depth of invasion LNM rate was 10% (4/40). None of the following tumours were observed with LNM: squamous cell carcinoma without LVSI (0/74); adenocarcinoma with

Conclusions. Lymph node assessment is essential in any tumour with LVSI or in adenocarcinoma with 3-5 mm depth of invasion. It can be omitted in squamous cell carcinoma without LVSI, in adenocarcinoma with

Original languageEnglish
Pages (from-to)282-286
Number of pages5
JournalGynecologic Oncology
Issue number2
Publication statusPublished - Aug 2020


  • Uterine cervical neoplasms
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Microinvasive
  • Lymph node metastasis
  • Survival

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