Preoperative predictors of pelvic and para-aortic lymph node metastases in cervical cancer

J Cancer Res Ther. 2019 Oct-Dec;15(6):1231-1234. doi: 10.4103/jcrt.JCRT_467_17.

Abstract

Aim: This study investigated potential preoperative predictors of pelvic lymph node (PLN) and para-aortic LN (PaLN) involvement in cervical cancer (CC).

Materials and methods: This study retrospectively analyzed 283 patients diagnosed with early (stage IA1-IIA) CC who underwent retroperitoneal LN dissection between January 1992 and February 2015. Several risk factors that are believed to influence PLN and PaLN involvement in CC were analyzed as follows: age >50 years, lymphovascular space invasion (LVSI), tumor size ≥2 cm, hemoglobin <12 g/dL, and nonsquamous cell histologic type.

Results: LVSI (odds ratio [OR] = 11.3, 95% confidence interval [CI] = 5.2-24.3) and tumor size (OR = 3.2, 95% CI = 1.4-7.2) were independent predictors of PLN involvement. None of the factors predicted PaLN involvement in a regression analysis. However, all nine patients who had PaLN involvement also had PLN involvement.

Conclusion: LVSI and tumor size independently increase the risk of PLN involvement.

Keywords: Cervical cancer; lymphovascular space invasion; para-aortic lymph node; pelvic lymph node.

MeSH terms

  • Adult
  • Clinical Decision-Making
  • Combined Modality Therapy
  • Disease Management
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Pelvis / pathology*
  • Preoperative Period*
  • Treatment Outcome
  • Tumor Burden
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / therapy