Risk Factor Assessment of Lymph Node Metastasis in Patients With FIGO Stage IB1 Cervical Cancer

Abstract

ObjectivesTo assess the risk factors of lymph node metastasis (LNM) in patients with FIGO stage (2009) IB1 cervical cancer (CC).MethodsPatients with FIGO stage IB1 CC who underwent radical resection between 2012 and 2018 were recruited. The risk factors for LNM were analysed. A recursive partitioning analysis (RPA) was used to divide the patients into risk groups and assess their risk of LNM.ResultsThe 5-year overall survival rate was 91.72%, while 80.0% and 93.5% for patients with or without LNM (P<0.05). Multivariable logistic regression analysis showed that lymphovascular invasion (LVI), depth of invasion (DI), tumour size (TS), squamous cell carcinoma (SCC) antigen level were independent risk factors (all P<0.05). Patients were divided into low-risk (no LVI, DI <1/2, TS <2 cm), intermediate-risk (no LVI, DI <1/2, TS ≥2 cm; no LVI, DI ≥1/2, normal SCC level; LVI, DI <1/2, TS <2 cm), and high-risk (no LVI, DI ≥1/2, SCC level ≥1.5 ng/ml; LVI, TS <2 cm, DI ≥1/2; LVI, TS ≥2 cm) groups by RPA according to these four factors. The incidence of LNM among the three groups was 0.00%, 4.40%, and 24.10%, respectively (all P<0.001). The 5-year overall survival rates differed among the groups (98.2%, 92.7%, 83.0%, respectively, P=0.001).ConclusionsLNM affects the prognosis of patients with FIGO stage IB1 CC. Lymphadenectomy may be avoided for patients in the low-risk group and recommended for those in the high-risk group. Whether dissection is performed in the intermediate-risk group depends on the lymph node biopsy results.

Feasibility and Diagnostic Accuracy of Ultrastaging in the Detection of Micrometastases in Sentinel and Non-sentinel Lymph Nodes in Cervical Cancer: A Single-Center Retrospective Study With a Five-Year Follow-Up Period

“…The five-year overall survival rate for early-stage cervical cancer is greater than 90% [ 25 ]. LNM significantly reduces patient survival [ 26 ]. According to Hosaka et al, in patients with stage IB-IIB cervical cancer, the five-year overall survival (OS) rate was 94.8% in those without LNM [ 27 ].…”

A preoperative prediction of lymph node metastasis in early cervical squamous cell cancer with hematologica - based model

“…The patient was initially classified as IB1 stage with endogenous tumor (size > 4cm), but according to 2018 FIGO staging the patient would have been classified as IB3 stage (equivalent to 2009 FIGO stage IB2). LVSI, deep stromal invasion, and tumor size are all known to be powerful predictors of LNM in CC patients 30 . It has also been reported that preoperative prediction of LNM in CC can be improved by including radiomics in the nomogram 12 , 17 .…”

Prognostic value of mesorectal package area in patients with locally advanced rectal cancer following neoadjuvant chemoradiotherapy: A retrospective cohort study

“…To predict the pCR rates of the patients with LARC after NCRT, the RPA was performed to classify patients with LARC into different risk groups. RPA was a useful statistical method for predicting patient risk in a number of cancers, including colorectal cancer, nasopharyngeal cancer, cervical cancer, and breast cancer, which could assist clinicians to determine the best medication regimen (30,(47)(48)(49). However, few studies used the RPA to forecast the NCRT response in patients with LARC.…”

“…There were more pieces of evidence that pelvic fat was related with the inflammatory response. PNI is a novel index to reflect the nutritional and inflammatory status of patients, and its clinical efficacy as a predictive factor in different malignancies has been established ( 47 , 48 ). In the present study, we found that both the PNI and MPA scores were effective at predicting NCRT response in patients with LARC.…”