Para-aortic lymph node involvement revisited in the light of the revised 2018 FIGO staging system for cervical cancer
Archives of Gynecology and Obstetrics, cilt.300, sa.3, ss.675-682, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 300 Sayı: 3
- Basım Tarihi: 2019
- Doi Numarası: 10.1007/s00404-019-05232-7
- Dergi Adı: Archives of Gynecology and Obstetrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.675-682
- Anahtar Kelimeler: Cervical cancer, Para-aortic lymph node, Metastasis, Radical hysterectomy, International Federation of Gynecology and Obstetrics, Staging
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This dual-institutional, retrospective study aimed to determine the clinicopathological risk factors for para-aortic lymph node (LN) metastasis among women who underwent radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy for 2009 FIGO stage IB1-IIA2 cervical cancer. Methods: Institutional cervical cancer databases of two high-volume gynecologic cancer centers in Ankara, Turkey were retrospectively analyzed. Women with 2009 FIGO stage IB1-IIA2 cervical cancer that had undergone radical hysterectomy with pelvic and para-aortic lymphadenectomy between January 2006 and December 2018 were included in the study. Patient data were analyzed with respect to para-aortic LN involvement and all potential clinicopathological risk factors for para-aortic LN metastasis were investigated. Results: A total of 522 women met the inclusion criteria. Pelvic LN metastasis was detected in 190 patients (36.4%), para-aortic LN metastasis in 48 patients (9.2%), isolated para-aortic LN metastasis in 4 (0.8%), and both pelvic and para-aortic LN metastasis in 44 (8.4%) women, respectively. The independent risk factors identified for para-aortic LN involvement included parametrial invasion (odds ratio [OR]: 3.57, 95% confidence interval [CI]: 1.65–7.72; p = 0.001), metastasized pelvic LN size > 1 cm (OR: 4.51, 95% CI: 1.75–11.64; p = 0.002), multiple pelvic LN metastases (OR: 3.83, 95% CI: 1.46–10.01; p = 0.006), and common iliac LN metastasis (OR: 2.97, 95% CI: 1.01–8.68; p = 0.04). A total of 196 (37.5%) patients exhibited at least one risk factor for para-aortic nodal disease. Conclusion: Parametrial invasion, metastasized pelvic LN size > 1 cm, multiple pelvic LN metastases, and common iliac LN metastasis seem to be independent predictors of para-aortic LN involvement.