Extent of pelvic lymphadenectomy in women with squamous cell carcinoma of the uterine cervix: Is there any prognostic value?

✍ Scribed by José Humberto Tavares Guerreiro Fregnani; Maria do Rosário Dias de Oliveira Latorre; Pablo Roberto Novik; Ademar Lopes; Júnea Cáris de Oliveira; Audrey Tieko Tsunoda; Fernando Augusto Soares

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 106 KB
• Volume: 100
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.21252

✦ Synopsis

Abstract

Background and Objectives

Some authors states that the removal of lymph node would only contribute towards assessing the lymph node status and regional disease control, without any benefit for the patients' survival. The aim of this paper was to assess the influence of the number of surgically dissected pelvic lymph nodes (PLN) on disease‐free survival.

Methods

Retrospective cohort study on 42 women presenting squamous cell carcinoma (SCC) of the uterine cervix, with metastases in PLN treated by radical surgery. The Cox model was used to identify risk factors for recurrence. The model variables were adjusted for treatment‐related factors (year of treatment, surgical margins and postoperative radiotherapy). The cutoff value for classifying the lymphadenectomy as comprehensive (15 PLN or more) or non‐comprehensive (<15 PLN) was determined from analysis of the ROC curve.

Results

Fourteen recurrences (32.6%) were recorded: three pelvic, eight distant, two both pelvic and distant, and one at an unknown location. The following risk factors for recurrence were identified: invasion of the deep third of the cervix and number of dissected lymph nodes <15.

Conclusions

Deep invasion and non‐comprehensive pelvic lymphadenectomy are possible risk factors for recurrence of SCC of the uterine cervix with metastases in PLN. J. Surg. Oncol. 2009;100:252–257. © 2009 Wiley‐Liss, Inc.