Oncol Res Treat. 2018;41(4):194-198. doi: 10.1159/000485840. Epub 2018 Mar 23.
Pelvic lymphadenectomy, which is the routine surgical treatment for early-stage cervical cancer, causes serious morbidity. The goal of the current retrospective study was to identify predictive factors of lymph node metastasis (LNM) in patients with early-stage cervical cancer.
The study included 496 patients diagnosed with stages IA2-IB1cervical cancer who underwent a radical hysterectomy with pelvic lymphadenectomy. The predictive factors of LNM were evaluated.
The incidence of LNM in this study was 4.6%. LNM was more common in patients with deep stromal invasion (DSI), tumor size > 2 cm, lymph vascular invasion and parametrial involvement (PI). Multivariate analysis showed DSI (p = 0.010) and PI (p = 0.005) were independently associated with LNM. The median follow-up time was 56.9 months. The patients with LNM had poorer 5-year overall survival (77.8%; 95% confidence interval (CI) 44.2-92.6) than the patients without LNM (98.2%; 95% CI 95.6-99.2; p = 0.002) and also poorer 5-year recurrence-free survival (65.5%; 95% CI 38.6-82.8) than the patients without LNM (90.2%; 95% CI 86.5-92.9; p < 0.001).
The predictive factors of pelvic lymph node metastasis in stage IA2-IB1 cervical cancer patients were DSI and PI. LNM was associated with poorer oncological outcomes.
盆腔淋巴结清扫术是早期宫颈癌的常规手术治疗方法，但会导致严重的发病率。本回顾性研究的目的是确定早期宫颈癌患者发生淋巴结转移（LNM）的预测因素。
本研究纳入了 496 例接受根治性子宫切除术和盆腔淋巴结清扫术的 IA2-IB1 期宫颈癌患者。评估了 LNM 的预测因素。
本研究中 LNM 的发生率为 4.6%。LNM 在深肌层浸润（DSI）、肿瘤大小>2cm、脉管侵犯和宫旁侵犯（PI）的患者中更为常见。多因素分析显示 DSI（p=0.010）和 PI（p=0.005）与 LNM 独立相关。中位随访时间为 56.9 个月。发生 LNM 的患者 5 年总生存率（77.8%，95%置信区间[CI] 44.2-92.6）低于未发生 LNM 的患者（98.2%，95%CI 95.6-99.2；p=0.002），5 年无复发生存率（65.5%，95%CI 38.6-82.8）也低于未发生 LNM 的患者（90.2%，95%CI 86.5-92.9；p<0.001）。
IA2-IB1 期宫颈癌患者发生盆腔淋巴结转移的预测因素是 DSI 和 PI。LNM 与较差的肿瘤学结局相关。
