Obstet Gynecol Sci.  2021 Jan;64(1):73-79. 10.5468/ogs.20016.

Clinical features that affect the number of pelvic lymph nodes harvested in patients with cervical cancer stage IB1 to IIA2

• Choi YJ
• Hwang WY
• Lee N
• Kim M
• Suh DH
• Kim K
• Kim YB
• No JH

• KMID: 2511567
• DOI: http://doi.org/10.5468/ogs.20016

Abstract

Objective
To investigate clinical features that affect the number of pelvic lymph nodes (PLNs) harvested and prognostic significance of the number of PLNs removed in patients with stage IB1 to IIA2 cervical cancer.
Methods
Data from patients with cervical cancer whom underwent hysterectomy with PLN dissection between June 2004 and July 2015 were reviewed retrospectively. Data on clinicopathologic factors including age, height, and weight were collected. Data on the presence of PLN metastasis on imaging studies prior to surgery, number of PLNs harvested, and presence of metastasis in the harvested PLNs were retrieved from medical records. Clinical features associated with the number of PLNs harvested were analyzed. Disease-free survival (DFS) and overall survival (OS) according to the number of PLNs harvested were analyzed.
Results
During the study period, 210 patients were included. The height and weight of patients and preoperative positive positron emission tomography findings were significantly associated with a higher number of PLNs harvested. As a pathologic factor, larger tumor size was associated with a higher number of PLNs harvested. Furthermore, a higher number of PLNs harvested was associated with a higher number of metastatic PLNs and patients undergoing postoperative concurrent chemoradiation therapy. Patient height and tumor size were independent factors affecting the number of PLNs harvested in multivariate analysis. However, the number of PLNs harvested was not associated with DFS or OS.
Conclusion
The number of PLNs harvested during surgery was associated with patient height; however, this was not related to the prognosis of the disease.

Keyword

Uterine cervical neoplasms; Lymph nodes; Lymph node excision

Figure

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  Fig. 1 Kaplan-Meier analysis of (A) disease free survival (DFS) and (B) overall survival (OS) post-surgery of both groups with a cut-off based on the average number of pelvic lymph nodes (PLNs) harvested.

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  Fig. 2 Kaplan-Meier analysis of (A) disease free survival (DFS) and (B) overall survival (OS) post-surgery in the pelvic lymph node (PLN) positive patients of both groups with a cut-off based on the average number of PLNs harvested.

Reference

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