New publication: Lymphatic drainage pathways from the cervix uteri

In a previous post, I mentioned I made a 3D interactive pdf for a medical publication. This paper was recently accepted at the Gynecologic Oncology journal and it is now available online: Lymphatic drainage pathways from the cervix uteri; implications for radical hysterectomy? I’ll try and do a little ‘Science in plain English’, for those interested but not all that familiar with the medical jargon.

A hysterectomy is a surgical treatment for early-stage cervical cancer where the womb is taken out. Typically also part of the lymphatic system in the region is removed to prevent the cancer from spreading. There are different types of hysterectomies that vary by how much tissue is taken out:

Science in plain English
The various types of hysterectomy described in a schematic way. Image courtesy of Wikipedia

The most successful treatment is a radical technique that takes out the cervix with a lot of the surrounding tissue, but has good outcome (i.e. the cancer does not come back and there is a good chance of survival). Up until now, there have not been many studies on how the lymphatic draining system in that region works in much detail. It was also unsure  if the fact that more of this system is taken out in this radical technique is a reason for the good outcome.

In this publication, my co-authors used microscopic imaging to see how the lymphatic system is organized in more detail. For this they colored the tissue with different stains that highlight certain cell types. Once we had these images, we made a three-dimensional virtual model of the region and the lymphatic system to get a better look at how these lymphatic structures were arranged in the area.

The conclusion of the article is that the good outcome of the radical treatment cannot be explained by the fact that more of the lymphatic draining system is taken out in the parametrium (see image), because there were no lymphatics from the cervix found in that specific area.

Of course this is just a simplified and short description of the full study, so if you are very interested in the exact results (or just want to look at the pictures), please read the article:

  • Lymphatic drainage pathways from the cervix uteri; implications for radical hysterectomy? A.C. Kraima, M. Derks, N.N. Smit, J.C. Van Munsteren, J. Van der Velde, G.G. Kenter, M.C. DeRuiter, Gynecologic Oncology, November 2013, (click for details)

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