Predictive Factors of Pelvic Lymph Node Metastasis in Early-Stage Cervical Cancer
Predictive Factors of Pelvic Lymph Node Metastasis in Early-Stage Cervical Cancer
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DOI：
10.1159/000485840
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发表时间：
2018-01-01
影响因子：
2.4
通讯作者：
Hanprasertpong, Jitti
中科院分区：
文献类型：
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作者：
Nanthamongkolkul, Kulisara;Hanprasertpong, Jitti
背景：盆腔淋巴结清扫术是早期宫颈癌的常规手术治疗方法，其并发症严重。本回顾性研究的目的是确定早期宫颈癌患者淋巴结转移（LNM）的预测因素。患者和方法：该研究纳入了496例诊断为IA 2-IB 1期宫颈癌的患者，这些患者接受了根治性子宫切除术和盆腔淋巴结清扫术。评估LNM的预测因素。结果：本组LNM的发生率为4.6%。LNM多见于有深部间质浸润（DSI）、肿瘤直径> 2cm、淋巴管浸润和宫旁组织受累（PI）的患者。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。LNM患者的5年总生存率较低（77.8%; 95%置信区间（CI）44.2-92.6）（98.2%; 95% CI 95.6-99.2; p = 0.002），5年无复发生存率也较差（65.5%; 95% CI 38.6-82.8）比无LNM的患者（90.2%; 95% CI 86.5-92.9; p < 0.001）。结论：DSI和PI是预测IA 2 ~ IB 1期宫颈癌盆腔淋巴结转移的重要因素。LNM与较差的肿瘤学结局相关。(c)2018 S. Karger GmbH，弗赖堡
Background: 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. Patients and Methods: 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. Results: 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). Conclusion: 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. (c) 2018 S. Karger GmbH, Freiburg