|Table of Contents|

The survival impact of pelvic lymph node metastasis on early cervical cancer patients using propensity score matching analysis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 15
Page:
2857-2865
Research Field:
Publishing date:

Info

Title:
The survival impact of pelvic lymph node metastasis on early cervical cancer patients using propensity score matching analysis
Author(s):
HUANG Fengxian1; GAO Hui1; CHEN Qingfen2; CAO Ximing1; ZHAO Shuhong1
1.Department of Radiotherapy,Shaanxi Provincial People's Hospital,Shaanxi Xi'an 710068,China;2.Department of Gynecology，Northwest University First Hospital，Shaanxi Xi'an 710043,China.
Keywords:
cervical cancer; pelvic lymph node metastasis; propensity score matching analysis; overall survival
PACS:
R737.33
DOI:
10.3969/j.issn.1672-4992.2024.15.026
Abstract:
Objective:To further verify and evaluate the survival impact of pelvic lymph node metastasis(PLNM) on early-stage cervical cancer patients by using propensity score matching analysis(PSM).Methods:A total of 533 patients who underwent radical cervical cancer surgery in Shaanxi Provincial People's Hospital between 2009.01.01 to 2016.12.31 were included,including 429 patients with negative pelvic lymph nodes(N0 group) and 104 patients with positive pelvic lymph nodes(N1 group).Using 1∶1 for PSM,a total of 104 pairs entered the post-matching analysis.Results:Before PSM,there were significant differences in the depth of cervical stromal invasion(DSI),lymphovascular space invasion(LVSI),tumor size and 2009 FIGO stage between the N0 group and the N1 group(P＜0.05).After PSM,there was no significant difference between the two groups in the clinical and pathological characteristics(P>0.05).Before PSM,the 5-year overall survival(OS)(85.8%) of the N0 group was significantly better than that of the N1 group(72.1%).After PSM,the 5-year OS(83.7%) of the N0 group was still significantly better than that of N1 group(72.1%) after PSM,the above differences were statistically significant(P＜0.05).The results of Cox single-factor and multi-factor analysis before PSM showed that DSI,LVSI,pelvic lymph node status and tumor size were independent prognostic factors in patients with cervical cancer.The results of Cox single-factor and multi-factor analysis after PSM showed that DSI,LVSI,and pelvic lymph node status were still independent prognostic factors in patients with cervical cancer.Conclusion:Pelvic lymph node metastasis is associated with poorer 5-year OS in patients with early-stage cervical cancer,both before and after PSM.

References:

[1] BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2024,74(3):229-263.
[2] SINGH D,VIGNAT J,LORENZONI V,et al.Global estimates of incidence and mortality of cervical cancer in 2020:a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative［J］.Lancet Glob Health,2023,11(2):e197-e206.
[3] XIE L,CHU R,WANG K,et al.Prognostic assessment of cervical cancer patients by clinical staging and surgical-pathological factor:A support vector machine-based approach［J］.Front Oncol,2020,10:1353-1354.
[4] 黄凤仙,李玢,曹席明,等.盆腔淋巴结转移数量对可手术宫颈鳞癌患者(Ⅰb1-Ⅱa2期)预后的预测价值［J］.现代肿瘤医学,2023,31(15):2904-2909. HUANG Fengxian,LI Bin,CAO Ximing,et al.The predictive value of the number of pelvic lymph node metastasis on the prognosis of operable cervicalsquamous cancer patients(stage Ⅰb1-Ⅱa2)［J］.Modern Oncology,2023,31(15):2904-2909.
[5] MATSUO K,MACHIDA H,MANDELBAUM RS,et al.Validation of the 2018 FIGO cervical cancer staging system［J］.Gynecol Oncol,2019,152(1):87-93.
[6] LI A,WANG L,JIANG Q,et al.Risk stratification based on metastatic pelvic lymph node status in stage ⅢC1p cervical cancer［J］.Cancer Manag Res,2020,12:6431-6439.
[7] WIDSCHWENDTER P,JANNI W,SCHOLZ C,et al.Prognostic factors for and pattern of lymph-node involvement in patients with operable cervical cancer［J］.Arch Gynecol Obstet,2019,300(6):1709-1718.
[8] HUANG Y,WEN W,LI X,et al.Prognostic value of lymphovascular space invasion in stage IA to IIB cervical cancer:A meta-analysis［J］.Medicine(Baltimore),2023,102(15):e33547.
[9] MCCOMAS KN,TORGESON AM,AGER BJ,et al.The variable impact of positive lymph nodes in cervical cancer:Implications of the new FIGO staging system［J］.Gynecol Oncol,2020,156(1):85-92.
10] TEN EM,HINTEN F,SMITS A,et al.Does the new FIGO 2018 staging system allow better prognostic differentiation in early stage cervical cancer?A dutch nationwide cohort study［J］.Cancers(Basel),2022,14(13):3140-3153.
11] CAO L,KONG W,LI J,et al.Analysis of lymph node metastasis and risk factors in 975 patients with FIGO 2009 stage ⅠA-ⅡA cervical cancer［J］.Gynecol Obstet Invest,2023,88(1):30-36.
12] MACHIDA H,MATSUO K,KOBAYASHI Y,et al.Significance of histology and nodal status on the survival of women with early-stage cervical cancer:validation of the 2018 FIGO cervical cancer staging system［J］.J Gynecol Oncol,2022,33(3):e26.
13] ASLAN K,HABERAL A,AKILLI H,et al.Prognostic value of the number of the metastatic lymph nodes in locally early-stage cervical cancer:squamous cell carcinoma versus non-squamous cell carcinoma［J］.Arch Gynecol Obstet,2021,304(5):1279-1289.
14] QIN F,PANG H,YU T,et al.Treatment strategies and prognostic factors of 2018 FIGO stage ⅢC cervical cancer:A review［J］.Technol Cancer Res Treat,2022,21:1-10.
[15] UPPAL S,GEHRIG PA,PENG K,et al.Recurrence rates in patients with cervical cancer treated with abdominal versus minimally invasive radical hysterectomy:A multi-institutional retrospective review study［J］.J Clin Oncol,2020,38(10):1030-1040.
[16] ZHANG M,DAI W,SI Y,et al.Comparison of minimally invasive versus abdominal radical hysterectomy for early-stage cervical cancer:An updated Meta-analysis［J］.Front Oncol,2021,11:762921.

Memo

Memo:
陕西省重点研发计划项目（编号：2022SF-489）;陕西省人民医院科技人才支持计划项目（编号：2022JY-24）
Last Update: 2024-06-28