Risk factors and prognosis of ⅠB-ⅡB cervical carcinoma with common iliac lymph node metastasis
- VernacularTitle:ⅠB～ⅡB期宫颈癌髂总淋巴结转移高危因素及对预后的影响
- Author:
Huang LONG
1
,
2
;
Zheng MIN
;
Liu JI-HONG
;
Xiong YING
;
Ding HUI
;
Tang LI
;
Wang HUI-YUN
Author Information
1. 华南肿瘤学国家重点实验室,广东,广州,510060
2. 中山大学肿瘤防治中心妇科,广东,广州,510060
- Keywords:
Common iliac lymph node;
metastasis;
cervical cancer;
risk factors;
prognosis
- From:Chinese Journal of Cancer
2010;29(4):475-480
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective: Pelvic lymph node metastasis is an important prognostic factor of cervical cancer.The prognosis of cervical cancer patients with common iliac lymph node metastasis is poor,but few systematic studies have been reported.This study was to investigate the characteristics,risk,treatment and prognosis of stage ⅠB-ⅡB cervical carcinoma patients with common iliac lymph node metastasis.Methods.A total of 960 patients with cervical cancer receiving radical hysterectomy and bilateral pelvic lymphadenectomy were selected from the hospitalized patients at Sun Yat-sen University Cancer Center between January 1995 and December 2005,and analyzed retrospectively.Results: Of the 960 patients,288(30.0%)had pelvic lymph node metastasis,and 45(4.7%)had positive common iliac lymph node.The 5-year overall survival rate(OS)of patients with common lilac lymph node metastasis was 46.1% and that of patients with other pelvic lymph node metastasis was 67.5%(P<0.05).Univariate analysis showed that clinical stage,serum level of squamous cell carcinoma antigen(SCC-Ag)>4 μg/L before treatment,depth of cervical invasion more than two thirds and positive parametrial margin were associated with common iliac lymph node metastasis(P<0.05).Patients with ≥ 3pelvic lymph node metastasis(excluding common iliac lymph node)or recurrence had poor prognosis(P<0.05).Factors predictive of common iliac lymph node metastasis on Logistic forward regression were SCC-Ag >4 μg/L(P=0.026,OR=2.303)before treatment and positive parametrial margin(P=0.045,OR=2.634).Conclusions: Cervical cancer patients with common iliac lymph node metastasis had poorer prognosis compared with patients with other pelvic lymph node metastasis.SCC-Ag >4 μg/L before treatment and positive parametrial margin were the independent predictive factors for common iliac lymph node metastasis of cervical carcinoma.Pelvic lymph node metastasis(excluding common iliac lymph node)≥3 or recurrence was prognostic factors for patients with common iliac lymph node metastasis.
