Radical hysterectomy with or without para-aortic lymphadenectomy for patients with stage IB2, IIA2, and IIB cervical cancer: outcomes for a series of 308 patients.

Abstract:

BACKGROUND:Although many studies have already shown that lymph node metastasis is one of the major prognostic factors for cervical cancer, the therapeutic significance of para-aortic lymphadenectomy for the surgical treatment of cervical cancer remains controversial. METHODS:A total of 308 patients diagnosed with stage IB2, IIA2, or IIB cervical cancer and treated with radical hysterectomy were retrospectively investigated to assess the incidence of para-aortic lymph node metastasis and the clinicopathological factors linked to cervical cancer prognosis. RESULTS:Para-aortic lymph node metastases were pathologically confirmed in 13 of the 136 patients (9.6 %) who underwent para-aortic lymphadenectomy. The incidence of para-aortic lymph node metastasis was significantly higher in the patients who had common iliac lymph node metastases (odds ratio 31.5, p < 0.001) according to logistic regression analysis. Common iliac lymph node metastasis was related to risk of recurrence (hazard ratio 2.43, p = 0.003) and death (hazard ratio 2.62, p = 0.007) in Cox regression analysis. Kaplan-Meier analysis and Cox regression analysis showed that para-aortic lymphadenectomy did not have a positive impact on survival in 308 patients or 140 pN1 patients, but para-aortic lymphadenectomy was related to better overall survival with a marginal trend toward significance (p = 0.053) in 30 patients with common iliac lymph node metastasis. CONCLUSIONS:Indication for para-aortic lymphadenectomy in the surgical treatment of stage IB2, IIA2, or IIB cervical cancer needs to be individualized. Patients with common iliac lymph node metastasis are possible candidates, and a prospective study is needed to clarify this issue.

journal_name

Int J Clin Oncol

authors

Tsuruga T,Fujimoto A,Kawana K,Mori M,Hasumi Y,Kino N,Tomio K,Miura S,Tanikawa M,Sone K,Miyamoto Y,Ikeda Y,Kojima S,Adachi K,Nagasaka K,Matsumoto Y,Arimoto T,Oda K,Nakagawa S,Horie K,Yasugi T,Yokota H,Osuga Y,

doi

10.1007/s10147-015-0907-3

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

359-366

issue

2

eissn

1341-9625

issn

1437-7772

pii

10.1007/s10147-015-0907-3

journal_volume

21

pub_type

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