Necessity of systematic pelvic lymphadenectomy for early-stage cervical cancer

To explore the risk factors for pelvic lymph node metastasis (PLNM) and recurrence in early-stage cervical cancer, then individualized management of patients with different risk levels can be carried out. Medical records of 735 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for the International Federation of Gynaecology and Obstetrics (FIGO, 2009) stage IA–IIA cervical cancer were reviewed. Clinical and pathological risk factors include age, FIGO stage, preoperative hemoglobin level, depth of stromal invasion, lymphovascular space invasion (LVSI), human papillomavirus (HPV) infection, and parametrial infiltration, tumor diameter, harvested lymph nodes, and pathological type were retrospectively analyzed. All patients were followed up for 5–10 years. Preoperative hemoglobin <110 g/L, FIGO stage II, LVSI, parametrial infiltration, and tumor diameter ≥4 cm were risk factors for PLNM and recurrence of early-stage cervical cancer after surgery (p < 0.05). PLNM was the independent risk factor for recurrence (p < 0.05). For patients with risk factors for PLNM, careful and systematic pelvic lymphadenectomy should be performed. Patients with PLNM have a high recurrence rate, and postoperative follow-up should be closely followed to ensure timely detection of recurrence and treatment Given the many complications of pelvic lymph node dissection for the low-risk population, further research is needed to determine whether pelvic lymphadenectomy should be attempted only in high-risk individuals.

Cervical cancer; Pelvic lymph node metastasis; Radical hysterectomy; Lymphovascular space invasion; Pelvic lymphadenectomy; Hemoglobin

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