Clinico pathological study of pelvic lymph node dissection in radical hysterectomy for the treatment of early cervical cancer [TI and TII]

ABSTRACT

To determine if the number of removed lymph nodes in radical hysterectomy with lymphadenectomy [RHL] influences survival of patients with early stage cervical cancer and to analyze the relation of different factors like patient age, tumour size and infiltration depth with the number of nodes examined in node- negative early stage cervical cancer patients. The mean age at the time of operation among the patients with negative nodes [group A] was 43.3 year [SD 11.5] [range 21-g2 years] in contrast to the patients with positive lymph nodes [group B] who had mean age of 47.0 year [SD 13.6] [range 25-80 years]. In this study the patients who underwent RHL between April 2002- and January 2007, 33 patients had negative nodes [group A] without adjuvant therapy and 13 had positive nodes [group B]. The Kaplan-Meier method and Cox regression model were used to detect statistical significance factors associated with excision of nodes were confirmed with linear regression models, The median number of removed nodes was 19 and 18 for group A and group B respectively. There was no significant relationship between the number of removed nodes and the cancer specific survival [CSS] or disease free survival [DFS] for patients of group A [p=0.25 and p 0.77 respectively] the number of removed nodes in group B was not significantly associated with CSS [P = 0.084] but it was for the DFS [p = 0.014] factors like patient age, tumour size and infiltration depth were not associated with the number of nodes. No relation was found between the number of negative nodes examined after RHL for the treatment of early stage cervical cancer and CSS or DFS. However, higher amount of removed lymph nodes leaded to better DFS for patient with positive nodes. It is suggested that patients with positive nodes benefit from a complete pelvic lymphadenectomy and a sufficient yield of removed nodes