Preoperative predictors of pelvic and para-aortic lymph node metastases in cervical cancer

Aim: This study investigated potential preoperative predictors of pelvic lymph node (PLN) and para-aortic LN (PaLN) involvement in cervical cancer (CC). Materials and Methods: This study retrospectively analyzed 283 patients diagnosed with early (stage IA1–IIA) CC who underwent retroperitoneal LN dissection between January 1992 and February 2015. Several risk factors that are believed to influence PLN and PaLN involvement in CC were analyzed as follows: age >50 years, lymphovascular space invasion (LVSI), tumor size ≥2 cm, hemoglobin <12 g/dL, and nonsquamous cell histologic type. Results: LVSI (odds ratio [OR] = 11.3, 95% confidence interval [CI] = 5.2–24.3) and tumor size (OR = 3.2, 95% CI = 1.4–7.2) were independent predictors of PLN involvement. None of the factors predicted PaLN involvement in a regression analysis. However, all nine patients who had PaLN involvement also had PLN involvement. Conclusion: LVSI and tumor size independently increase the risk of PLN involvement