Uterine cervix cancerThe size of the metastatic lymph node is an independent prognostic factor for the patients with cervical cancer treated by definitive radiotherapy
Section snippets
Patients
The medical records of 274 consecutive cervical cancer patients treated with definitive radiotherapy from August 2003 to April 2008 at the National Cancer Center, Korea, were reviewed. Six patients were excluded from the analysis for the following reasons. Patients who did not undergo brachytherapy (n = 2) were excluded; one patient who suffered grade 3 acute gastrointestinal toxicity from the external beam radiotherapy refused further treatment, and one other patient who showed partial response
Lymph node size and treatment outcomes
At diagnosis, 57% (155/270) of the patients had metastatic LN based on the imaging studies. Of these, 36.8% (57/155) had lymph nodes with a short axis of 15 mm or greater. Fig. 1 shows the overall survival rate respective to the LN group by size. There was a significant decrease in the survival rate as LN size increases over 1.5 cm. When patients with LN size ⩾1.5 cm were further divided into 3 size categories (1.5–2 cm, 2–3 cm, ⩾3 cm), there was no significant difference in the survival rate within
Discussion
Definitive radiotherapy with cisplatin-based concurrent chemotherapy is the most widely performed treatment method for patients with locally advanced cervical cancer. Considering that the non-operative treatment approach is more frequently used in this disease, accurate clinical staging is of utmost importance in predicting the prognosis and in individualizing the treatment method of cervical cancer. LN metastasis can be most accurately determined by surgical biopsy; however, radiologic images
Acknowledgement
This study was supported by Grant No. 1110540 from the National Cancer Center, Korea (Dr. Kim).
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