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Original Research

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Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?

  • Pedrada Innao1
  • Nontawat Benjakul2
  • Woraphot Chaowawanit1,*,

1Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 10300 Bangkok, Thailand

2Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 10300 Bangkok, Thailand

DOI: 10.31083/j.ejgo4206182 Vol.42,Issue 6,December 2021 pp.1262-1269

Submitted: 25 June 2021 Accepted: 11 August 2021

Published: 15 December 2021

*Corresponding Author(s): Woraphot Chaowawanit E-mail: woraphot@nmu.ac.th

Abstract

Objective: To determine the number of lymph nodes obtained from radical hysterectomy with pelvic lymphadenectomy (RHPL) and survival rates of the early-stage cervical cancer patients with various numbers of removed lymph nodes (RLNs) and metastatic lymph nodes (MLNs). Materials and methods: 407 patients with early-stage cervical cancers who underwent RHPL were included in this study. We reviewed all medical records from January 2005–June 2020 and excluded the patients who had incomplete medical record, loss of follow-up visits and received neo-adjuvant chemotherapy. Results: Three-hundred-and-fifty-four patients were analyzed. The median time of follow-up was 44.3 months, the average number of RLNs was 23 (range 7–29) and 91.7% of our cases had >12 RLNs. MLNs were found in 36 cases (10.2%). The patients with RLNs <12 had a significantly lower 5-year cancer-specific survival (CSS) compared to those with RLNs >12 (73.6 % and 97.0%, respectively, p-value < 0.001) but 5-year progression-free survival (PFS) was not different between both groups. Based on lymph node status, the 5-year PFS and CSS of node-negative vs. node-positive patients were 99.3% vs. 76.2% and 97.5% vs. 74.0%, respectively. Conclusion: An extensive lymphadenectomy had a survival benefit in early-stage cervical cancer patients. The patients with RLNs >12 had better 5-year CSS. MLNs and RLNs <12 are significant prognostic factors for PFS and CSS.

Keywords

Early-stage cervical cancer; Lymphadenectomy; Number of lymph node; Survival outcome

Cite and Share

Pedrada Innao,Nontawat Benjakul,Woraphot Chaowawanit. Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?. European Journal of Gynaecological Oncology. 2021. 42(6);1262-1269.

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