Significance of the Number and the Location of Metastatic Lymph Nodes in Locally Recurrent or Persistent Cervical Cancer Patients Treated with Salvage Hysterectomy plus Lymphadenectomy.
Significance of the Number and the Location of Metastatic Lymph Nodes in Locally Recurrent or Persistent Cervical Cancer Patients Treated with Salvage Hysterectomy plus Lymphadenectomy.
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DOI：
10.3390/curroncol29070385
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发表时间：
2022-07-11
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影响因子：
--
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我们回顾性研究了局部复发或持续性宫颈癌患者淋巴结转移的意义，在以前的照射领域，随后挽救子宫切除术。临床数据从病历回顾中获得，通过比较复发和生存率，研究淋巴结转移的存在、数量（1-2 vs ≥3）和位置（盆腔vs盆腔+主动脉旁）对预后的影响。本研究共纳入50例患者，其中21例（42.0%）显示淋巴结转移的病理学证据（淋巴结阳性组）。单变量和多变量分析均显示淋巴结转移是术后复发的独立预后因素（风险比（HR）5.36; 95%CI 1.41-6.66; p = 0.0020）。在淋巴结阴性和淋巴结阳性组中，挽救手术后复发的主要部位分别是内脏器官和淋巴结。≥3个淋巴结转移患者的生存率与1-2个淋巴结转移患者相似。盆腔淋巴结转移患者的生存率与盆腔和腹主动脉旁淋巴结转移患者相似。对于局部复发或持续性宫颈癌行挽救性子宫切除术加淋巴结清扫术的患者，淋巴结转移的存在，而不是数量或位置，是术后复发的独立不良预后因素。
We retrospectively investigated the significance of metastatic lymph nodes in patients with locally recurrent or persistent cervical cancer in a previously irradiated field and subsequently had salvage hysterectomy. Clinical data were obtained from a chart review, and the prognostic impact of the presence, number (1–2 versus ≥3), and location (pelvic versus pelvic plus para-aortic) of lymph node metastasis was investigated by comparing recurrence and survival. In total, 50 patients were included in this study, of which 21 (42.0%) showed pathological evidence of lymph node metastasis (node-positive group). Both the univariate and multivariate analyses showed that lymph node metastasis was an independent prognostic factor for postoperative recurrence (hazard ratio (HR) 5.36; 95% CI 1.41–6.66; p = 0.0020). The predominant sites of recurrence after salvage surgery were the visceral organs and lymph nodes in the node-negative and node-positive groups, respectively. Patients with ≥3 node metastases showed similar survival to those with 1–2 node metastases. Patients with pelvic node metastasis showed similar survival to those with pelvic and para-aortic node metastases. The presence, not number or location, of lymph node metastasis was an independent poor prognostic factor for post-operative recurrence in patients who developed locally recurrent or persistent cervical cancer treated with salvage hysterectomy plus lymphadenectomy.
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影响因子：
4.6
作者：
Kwon J;Eom KY;Kim YS;Park W;Chun M;Lee J;Kim YB;Yoon WS;Kim JH;Choi JH;Chang SK;Jeong BK;Lee SH;Cha J
通讯作者：
Cha J
DOI：
10.1056/nejmoa1309748
发表时间：
2014-02-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Tewari KS;Sill MW;Long HJ 3rd;Penson RT;Huang H;Ramondetta LM;Landrum LM;Oaknin A;Reid TJ;Leitao MM;Michael HE;Monk BJ
通讯作者：
Monk BJ
影响因子：
3.8
作者：
Takekuma M;Takahashi F;Mabuchi S;Kudaka W;Horie K;Ikeda M;Shikama A;Mitsuhashi A;Nagao S;Suzuki S;Mizuno M;Nishio S;Tokunaga H;Ota Y;Kasamatsu T;Kitagawa R;Toita T;Kobayashi H;Ishikawa M;Yaegashi N
通讯作者：
Yaegashi N
DOI：
10.1016/j.jogoh.2021.102190
发表时间：
2021-07-07
影响因子：
1.9
作者：
Mabuchi, Seiji;Shimura, Kotaro;Matsumoto, Yuri
通讯作者：
Matsumoto, Yuri
影响因子：
3.7
作者：
Querleu D;Cibula D;Abu-Rustum NR
通讯作者：
Abu-Rustum NR