Lymph node ratio may predict the benefit of postoperative radiotherapy in node-positive cervical cancer

نویسندگان

  • Juan Zhou
  • Qiong-Hua Chen
  • San-Gang Wu
  • Zhen-Yu He
  • Jia-Yuan Sun
  • Feng-Yan Li
  • Huan-Xin Lin
  • Ke-Li You
چکیده

The standard treatment for node-positive cervical cancer after radical hysterectomy is pelvic radiotherapy and concurrent chemotherapy. Given the potential toxicity of postoperative radiotherapy, we used the lymph node ratio (LNR) to assess the benefit of postoperative radiotherapy in lymph node-positive cervical cancer patients. Data from the Surveillance Epidemiology and End Results database (1988-2010) were analyzed using Kaplan-Meier and Cox regression proportional hazard analysis. A total of 2,269 eligible patients were identified (median follow-up, 78.0 months); 1,863 (82.1%) patients received postoperative radiotherapy. In both univariate and multivariate analysis multivariate analysis, a higher LNR was significantly associated with a poorer outcome. A LNR > 0.16 was associated with poorer cervical cancer-related survival (CCSS) (hazard Ratio [HR] 1.376, confidence interval [CI] 1.082-1.750; P < 0.001) and overall survival (OS) (HR 1.287, CI 1.056-1.569; P = 0.012). Postoperative radiotherapy was only associated with survival benefits in patients with a LNR > 0.16 (CCSS, P < 0.001; OS, P < 0.001) and not in patients with a LNR ≤ 0.16 (CCSS, P = 0.620; OS, P = 0.167); these trends were not affected by number of removed lymph nodes. A higher LNR is associated with a poorer survival in lymph node-positive cervical cancer. The survival benefits of postoperative radiotherapy appear to be limited to patients with a LNR > 0.16.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Standardization of whole breast radiotherapy is required for safe omission of axillary lymph node dissection in breast cancer patients

Background: The purpose of this study was to assess the dose distribution and coverage of level Ⅰ-Ⅱ axillary lymph nodes during whole breast tangential field radiotherapy (RT) after breast-conserving surgery in patients with breast cancer. Materials and Methods: The level Ⅰ-Ⅱ axillary lymph node volumes were retrospectively contoured by a single radiation oncologist based on computed tomography...

متن کامل

Sentinel lymph node in cervical cancer

Background: Cervical cancer is the second most common type of cancer among women. Effective screening programs can help cancer detection in early phases and reduce death. Metastasis to lymph nodes is one of the most prognostic factors in patients who underwent surgery. Also, a positive result from pathology report alert oncologist as a cause of death. Sentinel lymph node biopsy has been widely ...

متن کامل

NEOADJUVANT CHEMOTHERAPY WITH VINCRISTINE AND CISPLATIN FOLLOWED BY RADICAL HYSTERECTOMY AND PELVIC LYMPH ADENECTOMY FOR FIGO STAGE IB BULKY CERVICAL CANCER

Twenty patients with bulky (>4 cm size) FIGO stage IB cervical cancer were treated with cisplatin 50 mg/m2 and vincristine 1 mg/m2, administered intravenously at 10-day intervals for a total of 3 courses before radical hysterectomy. A complete clinical response was noted in 1 patient (5%) and partial response in 5 (25%). Fourteen patients (70%) had stable disease. There was no grade 3 toxic...

متن کامل

Diagnostic Accuracy of CT Scan for Detection of Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma in Comparison with Histopathological Analysis After Neck Dissection

Objectives: Presence/absence of cervical lymph node metastasis plays a critical role in prognosis and survival of patients with oral squamous cell carcinoma (SCC). This study was designed to assess the diagnostic accuracy of computed tomography (CT) scan for detection of cervical lymph node metastasis in oral SCC in comparison with histopathological analysis after neck dissection Methods: In...

متن کامل

Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 7  شماره 

صفحات  -

تاریخ انتشار 2016