title: The prognostic significance of multiple pelvic node metastases in cervical cancer patients treated with radical hysterectomy plus adjuvant chemoradiotherapy.
abstract: OBJECTIVE
  We investigated the prognostic significance of multiple pelvic node metastases in cervical cancer patients who were treated with radical hysterectomy plus adjuvant chemoradiotherapy.
  
  
  METHODS
  We retrospectively reviewed the medical records of 311 patients with International Federation of Gynecology and Obstetrics stage IB1-IIB cervical cancer who had been treated with radical hysterectomy plus adjuvant radiotherapy (RT) between January 1998 and December 2008. Of these, 119 received adjuvant RT and 192 received adjuvant concurrent chemoradiotherapy (CCRT) postoperatively. Multivariate analysis for progression-free survival (PFS) was performed using the Cox proportional hazards regression model to investigate the prognostic significance of pelvic node metastases in the 2 treatment groups. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.
  
  
  RESULTS
  Multivariate analysis demonstrated pelvic node metastasis to be an independent prognostic factor for shorter PFS in both treatment groups. When the node-positive patients were analyzed according to the number of positive pelvic nodes, we found that the patients with multiple pelvic node metastases (≥3) displayed significantly shorter PFS than those with 1 or 2 pelvic node metastases in the RT group. In contrast, in the CCRT group, the PFS of the patients with multiple pelvic node metastases (≥3) was similar to that observed of the patients with 1 or 2 pelvic node metastases.
  
  
  CONCLUSIONS
  The presence of multiple pelvic node metastases was not an independent predictor of shorter PFS in the CCRT group.
authors.affiliation: Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Okazawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Mabuchi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Suzuki
authors.forename: Yukinobu
authors.initials: Y
authors.lastname: Ohta
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Shoji
authors.initials: S
authors.lastname: Kamiura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010388:Pelvis; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D055815:Young Adult