期刊论文详细信息
Cancer Cell International
Combining the negative lymph nodes count with the ratio of positive and removed lymph nodes can better predict the postoperative survival in cervical cancer patients
Quan Hao2  Xiubao Ren1  Jing Tian2  Lei Zhang3  Ying Chen3 
[1] Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China;Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China;Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
关键词: Prognosis;    Pelvic lymphadenectomy;    Lymph node;    Cervical cancer;   
Others  :  794462
DOI  :  10.1186/1475-2867-13-6
 received in 2012-08-21, accepted in 2013-01-29,  发布年份 2013
PDF
【 摘 要 】

Background

To evaluate the impacts of the negative lymph nodes (NLNs) count on the prognostic prediction of the ratio of positive and removed lymph nodes (RPL) in cervical cancer patients after radical hysterectomy and pelvic lymphadenectomy (RHPL).

Methods

The positive and negative lymph node counts were calculated for 609 postoperative cervical cancer patients. The 5-year survival rate (5-YSR) was examined according to clinicopathologic variables. Cox regression was used to identify independent prognostic factors.

Results

The NLNs count cutoffs were determined to be 10 and 25 with 5-YSR of 62.8% and 80.5%. The RPL of 13 patients who had the NLNs count of 10 or fewer was >20%. Among 242 patients who had 10 < NLNs count ≤ 25, 194 without positive nodes had the 5-YSR of 77.8%, 31 with 0% < RPL ≤ 5% had the 5-YSR of 3.2%, 15 with RPL > 20% had died when follow-up was completed. Among 354 patients who had NLNs count >25, 185 without positive nodes had the 5-YSR of 87.6%, 6 with 0% < RPL ≤ 5% had the 5-YSR of 25%, 15 with 5% < RPL ≤ 20% had the 5-YSR of 4.5%, and 2 with RPL >20% had died when follow-up was completed. Furthermore, stage, histologic grade and RPL were independently correlated with overall survival of cervical cancer patients after RHPL in the multivariate analysis.

Conclusions

RPL was an independent prognostic factor. The NLNs count is a key factor for improvement of survival prediction of RPL in cervical cancer.

【 授权许可】

   
2013 Chen et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140705070020653.pdf 513KB PDF download
Figure 2. 35KB Image download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】
  • [1]Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin 2011, 61:69-90.
  • [2]Sevin BU, Nadji M, Lampe B, Lu Y, Hilsenbeck S, Koechli O, et al.: Prognostic factors in early stage cervical carcinoma treated with radical hysterectomy. Cancer 1995, 76:1978-1986.
  • [3]Kim HS, Park NH, Wu HG, Cho JY, Chung HH, Kim JW, et al.: Matched-case comparison for the role of surgery in FIGO stage Ib1–IIa squamous cell carcinoma of cervix and suspicious para-aortic lymph node metastasis. Ann Surg Oncol 2009, 16:133-139.
  • [4]Hosaka M, Watari H, Mitamura T, Konno Y, Odagiri T, Kato T, et al.: Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy. Int J Clin Oncol 2011, 16:33-38.
  • [5]Pieterse QD, Kenter GG, Gaarenstroom KN, Peters AA, Willems SM, Fleuren GJ, et al.: The number of pelvic lymph nodes in the quality control and prognosis of radical hysterectomy for the treatment of cervical cancer. Eur J Surg Oncol 2007, 33:216-221.
  • [6]Kim HS, Kim JH, Chung HH, Kim HJ, Kim YB, Kim JW, et al.: Significance of numbers of metastatic and removed lymph nodes in FIGO stage IB1 to IIA cervical cancer: primary surgical treatment versus neoadjuvant chemotherapy before surgery. Gynecol Oncol 2011, 121:551-557.
  • [7]Shah M, Lewin SN, Deutsch I, Burke WM, Sun X, Herzog TJ, et al.: Therapeutic role of lymphadenectomy for cervical cancer. Cancer 2011, 117:310-317.
  • [8]Prapaporn S, Kittipat C, Surapan K: Pelvic node removal and disease-free survival in cervical cancer patients treated with radical hysterectomy and pelvic lymphadenectomy. Int J Gynecol Obstet 2012, 116:43-46.
  • [9]Soliman PT, Frumovitz M, Sun CC, Dos Reis R, Schmeler KM, Nick AM, et al.: Radical hysterectomy: a comparison of surgical approaches after adoption of robotic surgery in gynecologic oncology. Gynecol Oncol 2011, 123:333-336.
  • [10]Metindir J, Bilir G: Impact of the ratio of metastatic to examined lymph nodes on the survival of early-stage cervical cancer patients. Onkologie 2009, 32:103-106.
  • [11]Polterauer S, Hefler L, Seebacher V, Rahhal J, Tempfer C, Horvat R, et al.: The impact of lymph node density on survival of cervical cancer patients. Brit J Cancer 2010, 103:613-616.
  • [12]Verleye L, Vergote I, Reed N, Ottevanger PB: Quality assurance for radical hysterectomy for cervical cancer: the view of the European organization for research and treatment of cancer–gynecological cancer group (EORTC-GCG). Ann Oncol 2009, 20:1631-1638.
  • [13]Kasamatsu T, Onda T, Sawada M, Kato T, Ikeda S: Radical hysterectomy for FIGO stage IIB cervical cancer: clinicopathological characteristics and prognostic evaluation. Gynecol Oncol 2009, 114:69-74.
  • [14]Marchet A, Mocellin S, Ambrosi A, Morgagni P, Garcea D, Marrelli D, et al.: Italian research group for gastric cancer (IRGGC). the ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastriccancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients. Ann Surg 2007, 245:543-552.
  • [15]Berger AC, Sigurdson ER, LeVoyer T, Hanlon A, Mayer RJ, Macdonald JS, et al.: Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes. J Clin Oncol 2005, 23:8706-8712.
  • [16]Wilson M, Rosato EL, Chojnacki KA, Chervoneva I, Kairys JC, Cohn HE, et al.: Prognostic significance of lymph node metastases and ratio in esophageal cancer. J Surg Research 2008, 146:11-15.
  • [17]Mahdi H, Thrall M, Kumar S, Hanna R, Seward S, Lockhart D, et al.: The prognostic impact of the ratio of positive lymph nodes on survival of epithelial ovarian cancer patients. J Surg Oncol 2011, 103:724-729.
  • [18]Chan JK, Kapp DS, Cheung MK, Osann K, Shin JY, Cohn D, et al.: The impact of the absolute number and ratio of positive lymph nodes on survival of endometrioid uterine cancer patients. Br J Cancer 2007, 97:605-611.
  • [19]Polterauer S, Khalil S, Zivanovic O, Abu-Rustum NR, Hofstetter G, Concin N, et al.: Prognostic value of lymph node ratio and clinicopathologic parameters in patients diagnosed with stage IIIC endometrial cancer. Obstet Gynecol 2012, 119:1210-1218.
  • [20]Schwarz RE, Smith DD: Clinical impact of lymphadenectomy extent in respectable gastric cancer of advanced stage. Ann Surg Oncol 2007, 14:317-328.
  • [21]Johnson PM, Porter GA, Ricciardi R, Baxter NN: Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer. J Clin Oncol 2006, 24:3570-3575.
  • [22]Cote RJ, Peterson HF, Chaiwun B, Gelber RD, Goldhirsch A, Castiglione-Gertsch M, et al.: Role of immunohistochemical detection of lymph-node metastases in management of breast cancer. International breast cancer study group. Lancet 1999, 354:896-900.
  • [23]International (Ludwig) Breast Cancer Study Group: Prognostic importance of occult axillary lymph node micrometastases from breast cancers. Lancet 1990, 355:1565-1568.
  • [24]Juretzka MM, Jensen KC, Longacre TA, Teng NN, Husain A: Detection of pelvic lymph node micrometastasis in stage IA2–IB2 cervical cancer by immunohistochemical analysis. Gynecol Oncol 2004, 93(1):107-111.
  • [25]Lentz SE, Muderspach LI, Felix JC, Ye W, Groshen S, Amezcua CA: Identification of micrometastases in histologically negative lymph nodes of early-stage cervical cancer patients. Obstet Gynecol 2004, 103(6):1204-10.
  • [26]Takeda N, Sakuragi N, Takeda M, Okamoto K, Kuwabara M, Negishi H, et al.: Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet Gynecol Scand 2002, 81:1144-1151.
  • [27]Smith DD, Schwarz RR, Schwarz RE: Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer: data from a large US-population database. J Clin Oncol 2005, 23:7114-7124.
  文献评价指标  
  下载次数:7次 浏览次数:24次