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Prognostic value of the number of the metastatic lymph nodes in locally early-stage cervical cancer: squamous cell carcinoma versus non-squamous cell carcinoma

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To clarify the prognostic value of the number of metastatic lymph nodes (mLNs) in squamous and non-squamous histologies among women with node-positive cervical cancer.

Methods

One hundred ninety-one node-positive cervical cancer patients who had undergone radical hysterectomy plus systematic pelvic and para-aortic lymphadenectomy followed by concurrent radiochemotherapy were retrospectively reviewed. The prognostic value of the number of mLNs was investigated in squamous cell carcinoma (SCC) v (n = 148) and non-SCC (n = 43) histologies separately with univariate log-rank test and multivariate Cox regression analyses.

Results

In SCC cohort, mLNs > 2 was significantly associated with decreased 5-year disease-free survival (DFS) [hazard ratio (HR) = 2.06; 95% confidence interval (CI) 1.03–4.09; p = 0.03) and overall survival (OS) (HR = 2.35, 95% CI 1.11–4.99; p = 0.02). However mLNs > 2 had no significant impact on 5-year DFS and 5-year OS rates in non-SCC cohort (p = 0.94 and p = 0.94, respectively). We stratified the entire study population as SCC with mLNs ≤ 2, SCC with mLNs > 2, and non-SCC groups. Thereafter, we compared survival outcomes. The non-SCC group had worse 5-year OS (46.8% vs. 85.3%, respectively; p < 0.001) and 5-year DFS rates (31.6% vs. 82.2%, respectively; p < 0.001) when compared to those of the SCC group with mLNs ≤ 2. However, the non-SCC group and the SCC group with mLNs > 2 had similar 5-year OS (46.8% vs. 65.5%, respectively; p = 0.16) and 5-year DFS rates (31.6% vs. 57.5%, respectively; p = 0.06).

Conclusion

Node-positive cervical cancer patients who have non-SCC histology as well as those who have SCC histology with mLNs > 2 seem to have worse survival outcomes when compared to women who have SCC histology with mLNs ≤ 2.

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Author information

Authors and Affiliations

  1. Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Koray Aslan & Mehmet Mutlu Meydanli

  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey

    Ali Haberal, Hüseyin Akıllı & Ali Ayhan

Authors
  1. Koray Aslan
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  2. Ali Haberal
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  3. Hüseyin Akıllı
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  4. Mehmet Mutlu Meydanli
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  5. Ali Ayhan
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Contributions

KA protocol/project development,data collection or management, data analysis, manuscript writing/editing, approved the version to be published. AH protocol/project development, manuscript writing/editing, approved the version to be published. HA data collection or management, manuscript writing/editing, approved the version to be published; MMM protocol/project development, data analysis, manuscript writing/editing, approved the version to be published. AA protocol/project development, manuscript writing/editing, approved the version to be published.

Corresponding author

Correspondence to Koray Aslan.

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The Institutional Review Board of Başkent University approved this study (IRB Approval Number:nKA 19/427).

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Aslan, K., Haberal, A., Akıllı, 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. Arch Gynecol Obstet 304, 1279–1289 (2021). https://doi.org/10.1007/s00404-021-06030-w

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