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Lymphatic anatomy: lymphatics of the cervix
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Anca Chelariu-Raicu, Katherine C. Kurnit
Cancer arising from the cervix has been reported to extend into the uterine corpus in 10%–30% of cases and into the uterine adnexa in 0.5%–1.6% of cases.17–19 Considering that as many as 17% of patients with early-stage cervix cancer have lymph node metastases,20–22 lateral spread from the pelvic lymph nodes (obturator, internal iliac, and external iliac lymph nodes) to the pelvic sidewall, to the common iliac lymph nodes, and then the paraaortic lymph nodes was thought to be the rule.20 However, studies using sentinel lymph node mapping have demonstrated that any of the pelvic lymph node groups, and even the paraaortic lymph nodes, may contain the first draining lymph node.23 Still, it is uncommon to find isolated paraaortic lymphatic spread in the absence of metastatic pelvic disease.20,24 Thus, as a group, the pelvic lymph nodes are still the most commonly involved sites of lymphatic spread.20 The likelihood of nodal involvement by disease stage among patients with early-stage disease is shown in Table 4.1.
Trilaciclib and the economic value of multilineage myeloprotection from chemotherapy-induced myelosuppression among patients with extensive-stage small cell lung cancer treated with first-line chemotherapy
Published in Journal of Medical Economics, 2021
Ivo Abraham, Uchenna Onyekwere, Baris Deniz, Donald Moran, Marc Chioda, Karen MacDonald, Huan Huang
The management costs for neutropenia, thrombocytopenia, and anemia were obtained from the retrospective claims-based analyses conducted by Wong et al.10 This retrospective matched cohort study assessed the incremental health care costs associated with AEs in adult patients with cancer (breast, digestive organs and peritoneum, genitourinary organs (including bladder and ovary and other uterine adnexa), lung, lymphatic and hematopoietic tissue, and skin) in the United States from 2006 to 201510. The management costs for febrile neutropenia were obtained from the retrospective claims-based analyses conducted by Weycker et al.23 This was a retrospective cohort study that assessed the clinical and economic risks and consequences of febrile neutropenia among patients with metastatic cancer (breast, colon/rectum, lung, ovaries, and prostate) in the United States from 2007 to 201123. All costs were adjusted for inflation to 2021 USD using the medical care component of the Consumer Price Index, according to the United States Bureau of Labor Statistics as of March 20219.
Role of perfusion CT in the evaluation of adnexal masses
Published in Journal of Obstetrics and Gynaecology, 2019
Veenu Singla, Nidhi Prabhakar, Niranjan Khandelwal, Gaurav Sharma, Tulika Singh, Neelam Aggarwal, Srinivasan Radhika
Uterine adnexa includes ovaries, fallopian tubes, their associated ligaments, vessels and connective tissue (Yakasai and Bappa 2012). Adnexal masses commonly arise from the ovaries or from the fallopian tubes. Incidentally detected adnexal masses are usually benign; however, approximately 1% of these lesions are malignant and require appropriate timely management (Slanetz et al. 1997; Liu and Zanotti 2011). Imaging has an important role in the management of adnexal masses. It helps to differentiate benign lesions from those that require further evaluation for possible malignancy. Imaging is also essential to evaluate the resectability of adnexal lesions as the presence of metastasis and the extent of a contiguous spread of malignant tumours can be clearly defined. The various imaging modalities used for this purpose include B-mode ultrasonography (USG), colour Doppler ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).