Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy.
OBJECTIVE
Lymph node metastasis (LNM) is known to be the most important prognostic factor in cervical cancer. We analyzed the number of positive lymph nodes and other clinicopathological factors as prognostic factors for survival in node-positive patients with cervical cancer.


METHODS
Node-positive cervical cancer patients (n = 108) who underwent radical hysterectomy and systematic lymphadenectomy in Hokkaido University Hospital from 1982 to 2002 were enrolled. Clinicopathological data including age, stage, histologic subtype, and the number of LNM sites were collected. The main outcome was the overall survival (OS) rate for Stage Ib-IIb patients treated with surgery and postoperative radiotherapy.


RESULTS
The 5-year OS rate of patients with 1 positive node was 93.3%, that for 2 nodes was 77.3%, for 3 nodes it was 33.3%, and for 4 or more it was 13.8%. The OS rate of patients with 1 or 2 LNM sites was significantly better than that for patients with more than 2 LNM sites. The OS rate of patients with adenocarcinoma (Ad) (28.6%) was significantly lower than that for patients with other histologic subtypes (squamous cell carcinoma; 66.7%, adenosquamous carcinoma; 75.0%, p = 0.0003). Multivariate analysis revealed that >2 LNM sites and Ad were independent prognostic factors for survival. The 5-year OS rate of patients with 1 or 2 LNM sites was 86.8%, a more favorable prognosis than the OS rates in other reports.


CONCLUSIONS
More than two LNM sites and adenocarcinoma were independent prognostic factors for node-positive patients with cervical cancer.
Hosaka
Masayoshi
M
Department of Gynecology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan. hosaka@med.hokudai.ac.jp
Watari
Hidemichi
H
Mitamura
Takashi
T
Konno
Yousuke
Y
Odagiri
Tetsuji
T
Kato
Tatsuya
T
Takeda
Mahito
M
Sakuragi
Noriaki
N
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007564:Japan; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*