Liu Chia-Hao, Yang Szu-Ting, Chao Wei-Ting, Lin Jeff Chien-Fu, Lee Na-Rong, Chang Wen-Hsun, Chen Yi-Jen, Wang Peng-Hui
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Department of Obstetrics and Gynecology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
Diagnostics (Basel). 2022 May 14;12(5):1230. doi: 10.3390/diagnostics12051230.
The incidence of lymph node (LN) involvement and its prognostic value based on radiological imaging in stage IIB cervical cancer (CC) remains unclear, and evidence regarding oncological outcomes of patients with stage IIB CC with LN metastases is limited. In this study we retrospectively reviewed the incidence and prognostic significance of pretreatment radiologic LN status in 72 patients with clinical stage IIB CC (FIGO 2009), with or without radiologic evidence of LN enlargement. An enlarged LN was defined as a diameter > 10 mm on CT/MRI. Progression-free survival (PFS) and overall survival (OS) were assessed. Radiologic LN enlargement of >10 mm was observed in 45.8% of patients with stage IIB CC. PFS (p = 0.0088) and OS rates (p = 0.0032) were significantly poorer in the LN group (n = 33) than in the non-LN group (n = 39). Univariate Cox analysis revealed that LN > 10 mm contributed to a higher rate of recurrence and mortality. In conclusion, nearly half of the patients with clinical stage IIB CC had enlarged LNs (>10 mm) identified during pretreatment radiologic evaluation, which negatively impacted prognosis. Our findings highlight the need to incorporate CT- or MRI-based LN assessment before treatment for stage IIB CC.
基于影像学检查的IIB期宫颈癌（CC）患者淋巴结（LN）转移发生率及其预后价值仍不明确，关于IIB期CC伴LN转移患者肿瘤学结局的证据有限。在本研究中，我们回顾性分析了72例临床IIB期CC（FIGO 2009）患者治疗前影像学LN状态的发生率及预后意义，这些患者有无LN增大的影像学证据。CT/MRI上直径>10 mm的LN定义为增大的LN。评估无进展生存期（PFS）和总生存期（OS）。IIB期CC患者中45.8%观察到影像学LN增大>10 mm。LN组（n = 33）的PFS（p = 0.0088）和OS率（p = 0.0032）显著低于非LN组（n = 39）。单因素Cox分析显示，LN>10 mm导致更高的复发率和死亡率。总之，近一半的临床IIB期CC患者在治疗前影像学评估中发现LN增大（>10 mm），这对预后有负面影响。我们的研究结果强调了在IIB期CC治疗前纳入基于CT或MRI的LN评估的必要性。
