Introduction/Background Objective: The aim of this study was to determine the prognostic value of lymph node ratio (LNR) in women with 2018 International Federation of Gynecology and Obstetrics stage IIIC (p) cervical cancer.
Methodology Methods: In this retrospective multicenter study, a total of 335 node-positive cervical cancer patients who had undergone radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy were included. All of the patients received adjuvant chemoradiation after surgery. LNR was defined as the ratio of positive lymph nodes (LNs) to the total number of LNs removed. The patients were categorized as two groups according to LNR; LNR<0.05 and LNR≥0.05. The prognostic value of LNR was investigated by univariate log-rank tests.
Results Results: The median age of the patients was 50 (range, 25–81) years. Two hundred forty (71.6%) 95 (28.4%) patients were FIGO stage IIIC1 and IIIC2, respectively. There were 263 (78.5%) women with squamous cell carcinoma, 37 (11.0%) with adenocarcinoma, 28 (8.4%) with adenosquamous cell carcinoma, and 7 (2.1%) with other histologies. The median number of the harvested nodes was 39 (range, 5–138). The median number of removed pelvic lymph nodes was 28 (range, 1–97) whereas the corresponding figure 1 was 11 (range, 1–54) for para-aortic lymph nodes. With a median follow-up period of 30 months, the 5-year overall survival rates for LNR<0.05 and LNR≥0.05 were 87.7%, and 64.5%, respectively (p<0.001). Patients with a LNR greater than 5 percent had 2.7-fold increased risk for death (HR:2.7, 95%CI: 1.5–4.7, p<0.001)
Conclusion Conclusion: LNR≥0.05 seems to be a prognostic factor for decreased overall survival in stage IIIC (p) cervical carcinoma.
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