Radical Hysterectomy with Pelvic Lymphadenectomy: Indications, Technique, and Complications
Identifieur interne : 003257 ( Pmc/Checkpoint ); précédent : 003256; suivant : 003258Radical Hysterectomy with Pelvic Lymphadenectomy: Indications, Technique, and Complications
Auteurs : Rachel A. Ware [États-Unis] ; John R. Van Nagell [États-Unis]Source :
- Obstetrics and Gynecology International [ 1687-9589 ] ; 2010.
Abstract
Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA2 and IB1 carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (<1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.
Url:
DOI: 10.1155/2010/587610
PubMed: 20871657
PubMed Central: 2939408
Affiliations:
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PMC:2939408Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA<sub>2</sub>
and IB<sub>1</sub>
carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (<1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Obstet Gynecol Int</journal-id>
<journal-id journal-id-type="iso-abbrev">Obstet Gynecol Int</journal-id>
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<issn pub-type="epub">1687-9597</issn>
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</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">20871657</article-id>
<article-id pub-id-type="pmc">2939408</article-id>
<article-id pub-id-type="doi">10.1155/2010/587610</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Radical Hysterectomy with Pelvic Lymphadenectomy: Indications, Technique, and Complications</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ware</surname>
<given-names>Rachel A.</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Nagell</surname>
<given-names>John R.</given-names>
<suffix>Jr.</suffix>
</name>
<xref ref-type="aff" rid="I1"></xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
</contrib-group>
<aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center and Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</aff>
<author-notes><corresp id="cor1">*John R. van Nagell Jr.: <email>jrvann2@email.uky.edu</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Liselotte Mettler</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2010</year>
</pub-date>
<pub-date pub-type="epub"><day>1</day>
<month>9</month>
<year>2010</year>
</pub-date>
<volume>2010</volume>
<elocation-id>587610</elocation-id>
<history><date date-type="received"><day>9</day>
<month>12</month>
<year>2009</year>
</date>
<date date-type="accepted"><day>11</day>
<month>6</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2010 R. A. Ware and J. R. van Nagell Jr.</copyright-statement>
<copyright-year>2010</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA<sub>2</sub>
and IB<sub>1</sub>
carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (<1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" position="float"><label>Figure 1</label>
<graphic xlink:href="OGI2010-587610.001"></graphic>
</fig>
<fig id="fig2" position="float"><label>Figure 2</label>
<graphic xlink:href="OGI2010-587610.002"></graphic>
</fig>
<fig id="fig3" position="float"><label>Figure 3</label>
<graphic xlink:href="OGI2010-587610.003"></graphic>
</fig>
<fig id="fig4" position="float"><label>Figure 4</label>
<graphic xlink:href="OGI2010-587610.004"></graphic>
</fig>
<fig id="fig5" position="float"><label>Figure 5</label>
<graphic xlink:href="OGI2010-587610.005"></graphic>
</fig>
<fig id="fig6" position="float"><label>Figure 6</label>
<graphic xlink:href="OGI2010-587610.006"></graphic>
</fig>
<fig id="fig7" position="float"><label>Figure 7</label>
<graphic xlink:href="OGI2010-587610.007"></graphic>
</fig>
<fig id="fig8" position="float"><label>Figure 8</label>
<graphic xlink:href="OGI2010-587610.008"></graphic>
</fig>
<fig id="fig9" position="float"><label>Figure 9</label>
<graphic xlink:href="OGI2010-587610.009"></graphic>
</fig>
<fig id="fig10" position="float"><label>Figure 10</label>
<graphic xlink:href="OGI2010-587610.010"></graphic>
</fig>
<fig id="fig11" position="float"><label>Figure 11</label>
<graphic xlink:href="OGI2010-587610.011"></graphic>
</fig>
<fig id="fig12" position="float"><label>Figure 12</label>
<graphic xlink:href="OGI2010-587610.012"></graphic>
</fig>
<fig id="fig13" position="float"><label>Figure 13</label>
<graphic xlink:href="OGI2010-587610.013"></graphic>
</fig>
<fig id="fig14" position="float"><label>Figure 14</label>
<graphic xlink:href="OGI2010-587610.014"></graphic>
</fig>
<fig id="fig15" position="float"><label>Figure 15</label>
<graphic xlink:href="OGI2010-587610.015"></graphic>
</fig>
<fig id="fig16" position="float"><label>Figure 16</label>
<graphic xlink:href="OGI2010-587610.016"></graphic>
</fig>
<table-wrap id="tab1" position="float"><label>Table 1</label>
<caption><p>Complications of Radical Hysterectomy.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author</th>
<th align="center" rowspan="1" colspan="1"># of Pts</th>
<th align="center" rowspan="1" colspan="1">Wound Infection (%)</th>
<th align="center" rowspan="1" colspan="1">Ureteral Injury (%)</th>
<th align="center" rowspan="1" colspan="1">Bladder Injury (%)</th>
<th align="center" rowspan="1" colspan="1">Blood Vessel Injury (%)</th>
<th align="center" rowspan="1" colspan="1">Urinary Tract Fistula (%)</th>
<th align="center" rowspan="1" colspan="1">Bladder Dysfunction (%)</th>
<th align="center" rowspan="1" colspan="1">Pulmonary Embolism or DVT (%)</th>
<th align="center" rowspan="1" colspan="1">Lympho-cysts (%)</th>
<th align="center" rowspan="1" colspan="1">Intestinal Obstruction (%)</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Cai et al. 2009 [<xref rid="B20" ref-type="bibr">20</xref>
]</td>
<td align="center" rowspan="1" colspan="1">480</td>
<td align="center" rowspan="1" colspan="1"> 0.63</td>
<td align="center" rowspan="1" colspan="1">0.83</td>
<td align="center" rowspan="1" colspan="1">0.83</td>
<td align="center" rowspan="1" colspan="1">0.21</td>
<td align="center" rowspan="1" colspan="1">1.0</td>
<td align="center" rowspan="1" colspan="1">12.9</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">5.8</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Manchana et al. 2009 [<xref rid="B21" ref-type="bibr">21</xref>
]</td>
<td align="center" rowspan="1" colspan="1">290</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">14.5</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">9.3</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Likic et al. <break></break>
2008 [<xref rid="B22" ref-type="bibr">22</xref>
]</td>
<td align="center" rowspan="1" colspan="1">529</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">1.32</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Pikaart et al. 2007 [<xref rid="B23" ref-type="bibr">23</xref>
]</td>
<td align="center" rowspan="1" colspan="1">201</td>
<td align="center" rowspan="1" colspan="1">4.0</td>
<td align="center" rowspan="1" colspan="1">1.5</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.5</td>
<td align="center" rowspan="1" colspan="1">7.5</td>
<td align="center" rowspan="1" colspan="1">1.5</td>
<td align="center" rowspan="1" colspan="1">1.0</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Wu et al. <break></break>
2006 [<xref rid="B24" ref-type="bibr">24</xref>
]</td>
<td align="center" rowspan="1" colspan="1">219</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">9.5</td>
<td align="center" rowspan="1" colspan="1">19.9</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">7.8</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Landoni et al. 2001 [<xref rid="B13" ref-type="bibr">13</xref>
]</td>
<td align="center" rowspan="1" colspan="1">109</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.92</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.92</td>
<td align="center" rowspan="1" colspan="1">14.7</td>
<td align="center" rowspan="1" colspan="1">2.8</td>
<td align="center" rowspan="1" colspan="1">11.9</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Zorlu et al. <break></break>
1998 [<xref rid="B25" ref-type="bibr">25</xref>
]</td>
<td align="center" rowspan="1" colspan="1">115</td>
<td align="center" rowspan="1" colspan="1">10.4</td>
<td align="center" rowspan="1" colspan="1">0.87</td>
<td align="center" rowspan="1" colspan="1">2.6</td>
<td align="center" rowspan="1" colspan="1">8.7</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Abr<inline-formula><mml:math id="M1"><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mtext>a</mml:mtext>
</mml:mrow>
<mml:mo>˜</mml:mo>
</mml:mover>
</mml:mrow>
</mml:math>
</inline-formula>
o et al. 1997 [<xref rid="B26" ref-type="bibr">26</xref>
]</td>
<td align="center" rowspan="1" colspan="1">302</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">2.9</td>
<td align="center" rowspan="1" colspan="1">9.2</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Finan et al. <break></break>
1996 [<xref rid="B27" ref-type="bibr">27</xref>
]</td>
<td align="center" rowspan="1" colspan="1">229</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">4.4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Magrina et al. 1995 [<xref rid="B28" ref-type="bibr">28</xref>
]</td>
<td align="center" rowspan="1" colspan="1">375</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.3</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.8</td>
<td align="center" rowspan="1" colspan="1">0.8</td>
<td align="center" rowspan="1" colspan="1">1.3</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Benedetti-Panici et al. 1993 [<xref rid="B29" ref-type="bibr">29</xref>
]</td>
<td align="center" rowspan="1" colspan="1">84</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">7.1</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">4.8</td>
<td align="center" rowspan="1" colspan="1">21.4</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ayhan et al. 1991 [<xref rid="B30" ref-type="bibr">30</xref>
]</td>
<td align="center" rowspan="1" colspan="1">270</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">16.2</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">6.4</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" position="float"><label>Table 2</label>
<caption><p>Five-year survival following radical hysterectomy for cervical cancer.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author</th>
<th align="center" rowspan="1" colspan="1"># of Pts</th>
<th align="center" rowspan="1" colspan="1">Stage</th>
<th align="center" rowspan="1" colspan="1">Size of Lesion (cm)</th>
<th align="center" rowspan="1" colspan="1">Depth of Stromal Invasion</th>
<th align="center" rowspan="1" colspan="1">Lymphvascular Space Invasion</th>
<th align="center" rowspan="1" colspan="1">Lymph Node Status</th>
<th align="center" rowspan="1" colspan="1">5-Year Survival (%)</th>
<th align="center" rowspan="1" colspan="1"><italic>P</italic>
value</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Sartori et al. 2007 [<xref rid="B33" ref-type="bibr">31</xref>
]</td>
<td align="center" rowspan="1" colspan="1">454</td>
<td align="center" rowspan="1" colspan="1">IB-IIA</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">All</td>
<td align="center" rowspan="1" colspan="1">80</td>
<td align="center" rowspan="1" colspan="1"><.01</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">88</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"> Positive</td>
<td align="center" rowspan="1" colspan="1">57</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ho et al. 2004 [<xref rid="B34" ref-type="bibr">32</xref>
]</td>
<td align="center" rowspan="1" colspan="1">197</td>
<td align="center" rowspan="1" colspan="1">IB-II</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">All</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">82</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Inner 2/3</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">88.8</td>
<td align="center" rowspan="1" colspan="1">.003</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"> Outer 1/3</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">73.8</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">89.5</td>
<td align="center" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">68.4</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">87.3</td>
<td align="center" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">67.2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ayhan et al. 2004 [<xref rid="B35" ref-type="bibr">33</xref>
]</td>
<td align="center" rowspan="1" colspan="1">393</td>
<td align="center" rowspan="1" colspan="1">IB</td>
<td align="center" rowspan="1" colspan="1">All</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">91</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">≤4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">91.0</td>
<td align="center" rowspan="1" colspan="1">.012</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">>4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">85.9</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">93.7</td>
<td align="center" rowspan="1" colspan="1">.009</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">86.0</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Landoni et al. 2001 [<xref rid="B13" ref-type="bibr">13</xref>
]</td>
<td align="center" rowspan="1" colspan="1">238</td>
<td align="center" rowspan="1" colspan="1">IB-IIA</td>
<td align="center" rowspan="1" colspan="1">All</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">79</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Tsai et al. 1999 [<xref rid="B12" ref-type="bibr">12</xref>
]</td>
<td align="center" rowspan="1" colspan="1">222</td>
<td align="center" rowspan="1" colspan="1">IB-IIA</td>
<td align="center" rowspan="1" colspan="1">All</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">76</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">≤4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">88</td>
<td align="center" rowspan="1" colspan="1">.0003</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">>4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">67</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">87</td>
<td align="center" rowspan="1" colspan="1">.0011</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">71</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Lai et al. 1999 [<xref rid="B36" ref-type="bibr">34</xref>
]</td>
<td align="center" rowspan="1" colspan="1">827</td>
<td align="center" rowspan="1" colspan="1">IB-II</td>
<td align="center" rowspan="1" colspan="1"><2</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">90.6</td>
<td align="center" rowspan="1" colspan="1">.0001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2–4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">82.7</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">>4</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">69.1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Inner 2/3</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">90.3</td>
<td align="center" rowspan="1" colspan="1">.0001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Outer 1/3</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">74.9</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">86.3</td>
<td align="center" rowspan="1" colspan="1">.0002</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">76.5</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">87.3</td>
<td align="center" rowspan="1" colspan="1">.0001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">68.2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Ware, Rachel A" sort="Ware, Rachel A" uniqKey="Ware R" first="Rachel A." last="Ware">Rachel A. Ware</name>
</noRegion>
<name sortKey="Van Nagell, John R" sort="Van Nagell, John R" uniqKey="Van Nagell J" first="John R." last="Van Nagell">John R. Van Nagell</name>
</country>
</tree>
</affiliations>
</record>
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