title: Prognostic significance of number of nodes removed in patients with node-negative early cervical cancer.
abstract: OBJECTIVE
  The aim of this study was to investigate whether the number of removed lymph nodes was associated with survival of patients with node-negative early cervical cancer and to analyze the prognostic significance of clinical and pathologic features in these patients.
  
  
  METHODS
  Patients with FIGO stage IA-IIB cervical cancer who underwent radical hysterectomy with lymphadenectomy without receiving preoperative therapy were reviewed retrospectively. Patients were all proved to have lymph-node-negative disease and classified into five groups based on the number of nodes removed. The Kaplan-Meier method and Cox's proportional hazards regression model were used in prognostic analysis.
  
  
  RESULTS
  The final dataset included 359 patients: 45 (12.5%) patients had ≤10 nodes removed, 93 (25.9%) had 11-15, 98 (27.3%) had 16-20, 64 (17.8%) had 21-25, and 59 (16.4%) had >25 nodes removed. There was no association between the number of nodes removed and survival of patients with node-negative early cervical cancer (χ2= 6.19, P = 0.185). Similarly, subgroup analyses for FIGO stage IB1-IIB also showed that the number of lymph nodes was not significantly related to survival in each stage. Multivariate analyses showed that histology and depth of invasion were independent prognostic factors for survival in these patients.
  
  
  CONCLUSIONS
  If a standardized lymphadenectomy is performed, the number of lymph nodes removed is not an independent prognostic factor for patients with node-negative early cervical cancer. Our study suggests that there is inconclusive evidence to support survival benefit of complete lymphadenectomy among these patients.
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China.
authors.forename: Siyue
authors.initials: S
authors.lastname: Mao
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Dong
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China.
authors.forename: Yiqi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guang Zhou, Guang Dong, China. msy108@sina.com.
authors.forename: Peihong
authors.initials: P
authors.lastname: Wu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
keywords: cervical cancer; lymphadenectomy; negative; number of lymph nodes; survival