IMR Press / EJGO / Volume 42 / Issue 6 / DOI: 10.31083/j.ejgo4206182
Open Access Original Research
Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?
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1 Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 10300 Bangkok, Thailand
2 Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 10300 Bangkok, Thailand
Eur. J. Gynaecol. Oncol. 2021, 42(6), 1262–1269; https://doi.org/10.31083/j.ejgo4206182
Submitted: 25 June 2021 | Revised: 27 July 2021 | Accepted: 11 August 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Objective: To determine the number of lymph nodes obtained from radical hysterectomy with pelvic lymphadenectomy (RHPL) and survival rates of the early-stage cervical cancer patients with various numbers of removed lymph nodes (RLNs) and metastatic lymph nodes (MLNs). Materials and methods: 407 patients with early-stage cervical cancers who underwent RHPL were included in this study. We reviewed all medical records from January 2005–June 2020 and excluded the patients who had incomplete medical record, loss of follow-up visits and received neo-adjuvant chemotherapy. Results: Three-hundred-and-fifty-four patients were analyzed. The median time of follow-up was 44.3 months, the average number of RLNs was 23 (range 7–29) and 91.7% of our cases had >12 RLNs. MLNs were found in 36 cases (10.2%). The patients with RLNs <12 had a significantly lower 5-year cancer-specific survival (CSS) compared to those with RLNs >12 (73.6 % and 97.0%, respectively, p-value < 0.001) but 5-year progression-free survival (PFS) was not different between both groups. Based on lymph node status, the 5-year PFS and CSS of node-negative vs. node-positive patients were 99.3% vs. 76.2% and 97.5% vs. 74.0%, respectively. Conclusion: An extensive lymphadenectomy had a survival benefit in early-stage cervical cancer patients. The patients with RLNs >12 had better 5-year CSS. MLNs and RLNs <12 are significant prognostic factors for PFS and CSS.

Keywords
Early-stage cervical cancer
Lymphadenectomy
Number of lymph node
Survival outcome
Figures
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