%0 Journal Article
%T Tertiary prevention strategies for micrometastatic lymph node cervical cancer: A systematic review and a prototype of an adapted model of care.
%A Śniadecki M
%A Guani B
%A Jaworek P
%A Klasa-Mazurkiewicz D
%A Mahiou K
%A Mosakowska K
%A Buda A
%A Poniewierza P
%A Piątek O
%A Crestani A
%A Stasiak M
%A Balaya V
%A Musielak O
%A Piłat L
%A Maliszewska K
%A Aristei C
%A Guzik P
%A Wojtylak S
%A Liro M
%A Gaillard T
%A Kocian R
%A Gołąbiewska A
%A Chmielewska Z
%A Wydra D
%J Crit Rev Oncol Hematol
%V 197
%N 0
%D 2024 May 26
%M 38527594
%F 6.625
%R 10.1016/j.critrevonc.2024.104329
%X OBJECTIVE: We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases.
METHODS: We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases. The electronic databases for literature and relevant articles were analysed.
RESULTS: Fifteen studies, (4882 patients), were included in our systematic review. While the results show that MICs significantly worsen prognosis in early CC. A tertiary prevention algorithm for low volume lymph node disease may stratify follow-up according to the burden of nodal disease and provide data that helps improve follow-up performance.
CONCLUSIONS: MICs worsen prognosis and should be managed as suggested by the algorithm. However, this algorithm must be externally validated. The clinical impact of isolated tumor cells (ITC) remains unclear.