Prognostic factors in locally advanced cervical cancer with pelvic lymph node metastasis
| العنوان: | Prognostic factors in locally advanced cervical cancer with pelvic lymph node metastasis |
|---|---|
| المؤلفون: | Pedro Jorge Joffily Pinto, Michael Jenwei Chen, Elson Santos Neto, Carlos Chaves Faloppa, Louise De Brot, Andrea Paiva Gadelha Guimaraes, Alexandre Andre Balieiro Anastacio da Costa, Glauco Baiocchi |
| المصدر: | International Journal of Gynecologic Cancer. 32:239-245 |
| بيانات النشر: | BMJ, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Oncology, Lymphatic Metastasis, Carcinoma, Squamous Cell, Humans, Lymph Node Excision, Uterine Cervical Neoplasms, Obstetrics and Gynecology, Female, Lymph Nodes, Neoplasm Recurrence, Local, Prognosis, Neoplasm Staging, Retrospective Studies |
| الوصف: | ObjectiveTo evaluate the prognostic impact of clinical and pathological variables and patterns of recurrence in patients with locally advanced cervical cancer with pelvic lymph node involvement (stage IIIC1 according to the 2018 FIGO Staging System).MethodsWe retrospectively analyzed 62 patients with locally advanced cervical cancer treated with curative intent with radiotherapy associated with chemotherapy in AC Camargo Cancer Center from January 2007 to December 2018.ResultsLymph node involvement was assessed by CT, MRI and positron emission tomography (PET)/CT in 28 (45.2%), 20 (32.3%) and 14 (22.6%) patients, respectively. The median tumor size was 5.0 cm and 72.6% of cases were squamous cell carcinomas. The median number of positive pelvic lymph nodes was three, and the median size of lymph nodes was 24 mm. Twenty-two (35.5%) patients had recurrence and 50% had only one site of recurrence. The sites of recurrence were pelvic, para-aortic and distant in 12 (19.4%), 6 (9.7%) and 16 (25.8%) patients, respectively. The 3 year overall and disease-free survival were 70.8% and 64.6%, respectively. Patients with adenocarcinoma had worse disease-free survival (HR 2.38; 95% CI 1.01 to 5.60; p=0.047) and overall survival (HR 2.99; 95% CI 1.14 to 7.75; p=0.025) compared with squamous cell carcinoma. In multivariate analysis, metastatic pelvic lymph node size of >2.5 cm (HR 4.38; 95% CI 1.65 to 11.6; p=0.003) and incomplete response to radiotherapy (HR 5.14; 95% CI 1.60 to 16.4; p=0.006) maintained the negative impact for overall survival.ConclusionsWe found that pelvic lymph node size and incomplete response to radiotherapy negatively impact overall survival in patients with advanced cervical cancer with pelvic lymph node involvement. This finding may help to stratify risk in this group of patients. |
| تدمد: | 1525-1438 1048-891X |
| DOI: | 10.1136/ijgc-2021-003140 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e16dad14dc3259f7bc7db6af32579100 https://doi.org/10.1136/ijgc-2021-003140 |
| رقم الانضمام: | edsair.doi.dedup.....e16dad14dc3259f7bc7db6af32579100 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15251438 1048891X |
|---|---|
| DOI: | 10.1136/ijgc-2021-003140 |