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The Prognostic Significance of Multiple Pelvic Node Metastases in Cervical Cancer Patients Treated With Radical Hysterectomy Plus Adjuvant Chemoradiotherapy
  1. Mika Okazawa, MD*,
  2. Seiji Mabuchi, MD, PhD,
  3. Fumiaki Isohashi, MD, PhD,
  4. Osamu Suzuki, MD, PhD§,
  5. Yukinobu Ohta, MD, PhD*,
  6. Masami Fujita, MD, PhD,
  7. Kiyoshi Yoshino, MD, PhD,
  8. Takayuki Enomoto, MD, PhD,
  9. Shoji Kamiura, MD, PhD* and
  10. Tadashi Kimura, MD, PhD
  1. * Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases; Departments of
  2. Obstetrics and Gynecology and
  3. Radiation Oncology, Osaka University Graduate School of Medicine; and
  4. § Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
  1. Address correspondence and reprint requests to Seiji Mabuchi, MD, PhD, Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. E-mail: smabuchi{at}gyne.med.osaka-u.ac.jp.

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.

  • Cervical cancer
  • Radical hysterectomy
  • Adjuvant radiotherapy
  • Chemoradiotherapy
  • Pelvic node metastasis
  • Survival

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Footnotes

  • The authors declare that they have no conflicts of interest.

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