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
de En
| WPRIM
| ID: wpr-740173
Bibliothèque responsable:
WPRO
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.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Récidive
/
Odds ratio
/
Tumeurs du col de l'utérus
/
Incidence
/
Études rétrospectives
/
Facteurs de risque
/
Études de cohortes
/
Hystérectomie
/
Noeuds lymphatiques
/
Métastase tumorale
Type d'étude:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Female
/
Humans
langue:
En
Texte intégral:
Journal of Gynecologic Oncology
Année:
2018
Type:
Article