Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Abstract

IntroductionCarcinoma of the cervix uteri is the second most common cancer and the third most common cause of cancer deaths in women worldwide (1,2). The definitive primary treatment for patients with early-stage disease consists of radiation therapy or radical hysterectomy with pelvic and/ or paraaortic lymph node dissection (3). Knowledge about prognosis and recurrence is critical for the management of early-stage cervical cancer. Lymph node involvement is an important risk factor for recurrence in patients with earlystage cervical cancer. The recurrence rate in lymph nodenegative patients was 10% and the 5-year survival rate ranged from 85%-90%. In contrast, the recurrence rate in lymph node-positive patients was 27% and the 5-year survival rate ranged from 20% to 74% depending on the number of nodes that were involved and the location and size of the metastases (4-6).In this retrospective study, we analyzed the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. These data may improve the management of early-stage cervical cancer to reduce the risk of recurrence and predict the recurrence patterns of early-stage cervical cancer. Materials and methodsThe medical records of patients diagnosed with stage IB cervical cancer and who were treated with type III radical hysterectomy, bilateral salpingo-oophorectomy, or systemic pelvic and paraaortic lymphadenectomy from January 1993 to December 2007 were evaluated retrospectively. The complete pathological data of 170 patients were evaluated. Patients who received neoadjuvant chemotherapy were excluded because chemotherapy is known to improve surgical pathological results (7).All of the patients were evaluated by rectovaginal examination under general anesthesia, computerized tomography of the upper abdomen and pelvic magnetic resonance imaging, or intravenous pyelography. Clinical Background/aim: To investigate the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. Materials and methods:We reviewed the medical records of 170 patients who had undergone type III radical hysterectomy and systematic lymphadenectomy from 1993 to 2007.Results: Among the patients in the study group, 115 did not have lymph node metastases, whereas 55 did. A total of 27 patients developed recurrences. Twelve were in the lymph node-negative group, and 15 were in the lymph node-positive group. The recurrence rate was higher in lymph node-positive group (27.3% versus 10.4%, P = 0.011). The recurrence pattern was not affected by lymph node involvement. However, distant recurrence was more common in the lymph node-positive group (53.3% versus 25%, P = 0.137). Additionally, distant failure was observed only in the patients in the lymph node-negative group who received adjuvant radiotherapy. In this group, 3 patients who did not receive adjuvant radiotherapy developed recurrences only in the pelvic region. Conclusion:The presence of lymph node involvement in stage IB cervical cancer does not affec...

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Risk factors for the recurrence of cervical cancer using MR-based T1 mapping: A pilot study

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