title: Surgical-pathologic risk factors of pelvic lymph node metastasis in stage Ib1-IIb cervical cancer.
abstract: OBJECTIVE
  To study the distribution characteristics and risk factors of cervical cancer lymph node metastasis (LNM).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Affiliated Hospital to Zunyi Medical College.
  
  
  METHODS
  404 women diagnosed with cervical cancer FIGO stage Ib1-IIa who underwent primary radical surgery and 104 women with Ib2-IIb tumors treated with neoadjuvant chemotherapy (NACT) before surgery.
  
  
  METHODS
  Clinicopathological data were collected and analyzed.
  
  
  METHODS
  Incidence of infiltration, metastasis and pelvic LNM.
  
  
  RESULTS
  In women without NACT, the incidence of infiltration, metastasis and LNM was 7.2, 17.6 and 15.8%, respectively. Metastasis and LNM were significantly associated with advanced FIGO stage and poorer histological grade. The incidence of multiple metastatic lymph nodes (MLNs), bilateral LNM, skip LNM, LNM in primary group and LNM in secondary group was 6.2, 3.0, 6.2%, 11.4 and 4.5%, respectively. Of the 111 MLNs, 13 (11.7%) were common iliac lymph nodes. In the NACT group, infiltration, metastasis and LNM were observed in 10 (9.6%), 24 (23.1%) and 21 (20.1%) of 104 women, respectively. Metastasis and LNM were significantly correlated with moderate cell differentiation.
  
  
  CONCLUSIONS
  High LNM risk is expected in tumors of IIa stage or higher and in moderately differentiated tumors. Skip metastasis and common iliac LNM are relatively common and therefore should not be neglected. Our results suggest that standardized and complete pelvic lymph node dissection under surgery is an important measure to ensure a therapeutic effect.
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Donglin
authors.initials: D
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Cai
authors.forename: Yan
authors.initials: Y
authors.lastname: Kuang
authors.forename: Jin
authors.initials: J
authors.lastname: Cao
authors.forename: Zehua
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy