Risk stratification models for para-aortic lymph node metastasis and recurrence in stage IB–IIB cervical cancer / 부인종양
Journal of Gynecologic Oncology
;
: e11-2018.
Article
in English
| WPRIM
| ID: wpr-740173
ABSTRACT
OBJECTIVE:
To examine the surgical-pathological predictors of para-aortic lymph node (PAN) metastasis at radical hysterectomy, and for PAN recurrence among women who did not undergo PAN dissection at radical hysterectomy.METHODS:
This is a retrospective analysis of a nation-wide cohort study of surgically-treated stage IB–IIB cervical cancer (n=5,620). Multivariate models were used to identify independent surgical-pathological predictors for PAN metastasis/recurrence.RESULTS:
There were 120 (2.1%) cases of PAN metastasis at surgery with parametrial involvement (adjusted odds ratio [aOR]=1.65), deep stromal invasion (aOR=2.61), ovarian metastasis (aOR=3.10), and pelvic nodal metastasis (single-node aOR=5.39 and multiple-node aOR=33.5, respectively) being independent risk factors (all, p20% of the study population) had PAN metastasis incidences of ≥4%. Among 4,663 clinically PAN-negative cases at surgery, PAN recurrence was seen in 195 (4.2%) cases that was significantly higher than histologically PAN-negative cases (2.5%, p=0.046). In clinically PAN-negative cases, parametrial involvement (adjusted hazard ratio [aHR]=1.67), lympho-vascular space invasion (aHR=1.95), ovarian metastasis (aHR=2.60), and pelvic lymph node metastasis (single-node aHR=2.49 and multiple-node aHR=8.11, respectively) were independently associated with increased risk of PAN recurrence (all, p15% of the clinically PAN-negative population) had 5-year PAN recurrence risks being ≥8%.CONCLUSION:
Surgical-pathological risk factors proposed in this study will be useful to identify women with increased risk of PAN metastasis/recurrence.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Odds Ratio
/
Uterine Cervical Neoplasms
/
Incidence
/
Retrospective Studies
/
Risk Factors
/
Cohort Studies
/
Hysterectomy
/
Lymph Nodes
/
Neoplasm Metastasis
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
Language:
English
Journal:
Journal of Gynecologic Oncology
Year:
2018
Type:
Article
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