OBJECTIVES: Pelvic lymph node involvement is a well-recognized prognostic factor in @entity2622 (CX). Limited knowledge exists about extranodal extension of the @entity5 outside the lymph node capsule, i.e. extracapsular spread (ECS). METHODS: Two hundred fifty-six cases of surgically treated CX (FIGO stage @entity3846 to IIB) with pelvic lymph node involvement were evaluated regarding the occurrence of extranodal spread of the metastatic deposits outside the lymph node capsule (ECS), determined on standardized handled lymphadenectomy specimens, regarding their impact of recurrent disease and overall survival during a median follow-up time of 62 months (95% CI 51-73 months). RESULTS: ECS was seen in 30.9% (79/256) of the cases. The occurrence of ECS showed a significant correlation to advanced stage disease (p=0.02), the number of involved nodes (p<0.001) and the size of metastatic deposits (p<0.01). The 5-year recurrence-free survival rate in @entity1 with ECS was significant lower compared to @entity1 without ECS (59.7% [95% CI: 46.3%-73.2%] versus 67.2% [95% CI: 58.9%-75.5%]; (p=0.04). The 5-year overall survival rate was significant lower in @entity1 with ECS (33.5% [95% CI: 20.6%-46.3%] vs. 60.5% [95% CI: 52.3%-68.6%]; p<0.001). In multivariate analysis, @entity5 stage, number of involved pelvic nodes, @entity5 differentiation and ECS were independent prognostic factors. CONCLUSIONS: The results indicate that extracapsular spread (ECS) of pelvic lymph node @entity3 is of prognostic @entity2622 . A revised FIGO/TNM classification system for pelvic @entity1600 is recommended: ECS 0 = lymph node involvement without extranodal spread of the metastatic deposits and @entity26476 = lymph node involvement with extranodal spread of the metastatic deposits.

Extracapsular extension of pelvic lymph node XXXX is of prognostic value in carcinoma of the cervix uteri.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity2622 :: ('MESH:D002583', 'Disease') :: ['impact in cervical carcinomas', 'cervical carcinoma'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['lymph node disease'] @entity3846 :: ('9479', 'Gene') :: ['IB1'] @entity26476 :: ('2319', 'Gene') :: ['ECS 1'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity3 :: (MESH:D009362,Disease) :: ['metastases']
