FIGO 2018 分期 IIICp 期宫颈癌患者转移淋巴结数量和淋巴结比值对预后的预测价值：一项多中心回顾性研究。

Predictive value of number of metastatic lymph nodes and lymph node ratio for prognosis of patients with FIGO 2018 stage IIICp cervical cancer: a multi-center retrospective study.

机构信息

Department of Midwifery, School of Health, Dongguan Polytechnic, Dongguan, 523808, China.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

出版信息

BMC Cancer. 2024 Aug 13;24(1):1005. doi: 10.1186/s12885-024-12784-8.

DOI:10.1186/s12885-024-12784-8

PMID:39138415

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11320992/

Abstract

BACKGROUND

To identify the cut-off values for the number of metastatic lymph nodes (nMLN) and lymph node ratio (LNR) that can predict outcomes in patients with FIGO 2018 IIICp cervical cancer (CC).

METHODS

Patients with CC who underwent radical hysterectomy with pelvic lymphadenectomy were identified for a propensity score-matched (PSM) cohort study. A receiver operating characteristic (ROC) curve analysis was performed to determine the critical nMLN and LNR values. Five-year overall survival (OS) and disease-free survival (DFS) rates were compared using Kaplan-Meier and Cox proportional hazard regression analyses.

RESULTS

This study included 3,135 CC patients with stage FIGO 2018 IIICp from 47 Chinese hospitals between 2004 and 2018. Based on ROC curve analysis, the cut-off values for nMLN and LNR were 3.5 and 0.11, respectively. The final cohort consisted of nMLN ≤ 3 (n = 2,378) and nMLN > 3 (n = 757) groups and LNR ≤ 0.11 (n = 1,748) and LNR > 0.11 (n = 1,387) groups. Significant differences were found in survival between the nMLN ≤ 3 vs the nMLN > 3 (post-PSM, OS: 76.8% vs 67.9%, P = 0.003; hazard ratio [HR]: 1.411, 95% confidence interval [CI]: 1.108-1.798, P = 0.005; DFS: 65.5% vs 55.3%, P < 0.001; HR: 1.428, 95% CI: 1.175-1.735, P < 0.001), and the LNR ≤ 0.11 and LNR > 0.11 (post-PSM, OS: 82.5% vs 76.9%, P = 0.010; HR: 1.407, 95% CI: 1.103-1.794, P = 0.006; DFS: 72.8% vs 65.1%, P = 0.002; HR: 1.347, 95% CI: 1.110-1.633, P = 0.002) groups.

CONCLUSIONS

This study found that nMLN > 3 and LNR > 0.11 were associated with poor prognosis in CC patients.

摘要

背景

确定转移性淋巴结数量（nMLN）和淋巴结比率（LNR）的截断值，以预测 FIGO 2018 期 IIICp 宫颈癌（CC）患者的结局。

方法

本研究通过倾向性评分匹配（PSM）队列研究，纳入了 2004 年至 2018 年期间 47 家中国医院接受根治性子宫切除术和盆腔淋巴结清扫术的 CC 患者。采用受试者工作特征（ROC）曲线分析确定临界 nMLN 和 LNR 值。采用 Kaplan-Meier 和 Cox 比例风险回归分析比较 5 年总生存率（OS）和无病生存率（DFS）。

结果

本研究共纳入了来自 47 家中国医院的 3135 例 FIGO 2018 期 IIICp CC 患者。基于 ROC 曲线分析，nMLN 和 LNR 的截断值分别为 3.5 和 0.11。最终队列分为 nMLN≤3（n=2378）和 nMLN＞3（n=757）组以及 LNR≤0.11（n=1748）和 LNR＞0.11（n=1387）组。在生存方面，nMLN≤3 与 nMLN＞3（PSM 后，OS：76.8% vs 67.9%，P=0.003；风险比 [HR]：1.411，95%置信区间 [CI]：1.108-1.798，P=0.005；DFS：65.5% vs 55.3%，P＜0.001；HR：1.428，95% CI：1.175-1.735，P＜0.001）以及 LNR≤0.11 和 LNR＞0.11（PSM 后，OS：82.5% vs 76.9%，P=0.010；HR：1.407，95% CI：1.103-1.794，P=0.006；DFS：72.8% vs 65.1%，P=0.002；HR：1.347，95% CI：1.110-1.633，P=0.002）两组之间存在显著差异。