title: Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer.
abstract: OBJECTIVE
  The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment.
  
  
  METHODS
  Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months.
  
  
  RESULTS
  The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ -1.05 LODDs. In multivariate analysis, ≥ -1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ -1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006).
  
  
  CONCLUSIONS
  LODDs ≥ -1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ -1.05, intensified chemotherapy might be required, considering the high rate of DF.
authors.affiliation: Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jeanny
authors.initials: J
authors.lastname: Kwon
authors.affiliation: Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Keun-Yong
authors.initials: KY
authors.lastname: Eom
authors.affiliation: Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In Ah
authors.initials: IA
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young-Beom
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: No
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kidong
authors.initials: K
authors.lastname: Kim
mesh_terms: D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy*
keywords: Log odds of positive lymph node; Lymph nodes; Prognosis; Uterine cervical neoplasms