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Extent of pelvic lymphadenectomy in women with squamous cell carcinoma of the uterine cervix: Is there any prognostic value?
Author(s) -
Fregnani José Humberto Tavares Guerreiro,
de Oliveira Latorre Maria do Rosário Dias,
Novik Pablo Roberto,
Lopes Ademar,
de Oliveira Júnea Cáris,
Tsunoda Audrey Tieko,
Soares Fernando Augusto
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21252
Subject(s) - medicine , lymphadenectomy , cervix , lymph node , retrospective cohort study , lymph , cohort , carcinoma , radiation therapy , surgery , gynecology , radiology , cancer , pathology
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.