Comparison of survival outcomes with or without Para-aortic lymphadenectomy in surgical patients with stage IB1-IIA2 cervical cancer in China from 2004 to 2016.

Abstract

BACKGROUND:

Current opinions on whether surgical patients with cervical cancer should undergo para-aortic lymphadenectomy at the same time are inconsistent. The present study examined differences in survival outcomes with or without para-aortic lymphadenectomy in surgical patients with stage IB1-IIA2 cervical cancer.

METHODS:

We retrospectively compared the survival outcomes of 8802 stage IB1-IIA2 cervical cancer patients (FIGO 2009) who underwent abdominal radical hysterectomy + pelvic lymphadenectomy (n = 8445) or abdominal radical hysterectomy + pelvic lymphadenectomy + para-aortic lymphadenectomy (n = 357) from 37 hospitals in mainland China.

RESULTS:

Among the 8802 patients with stage IB1-IIA2 cervical cancer, 1618 (18.38%) patients had postoperative pelvic lymph node metastases, and 37 (10.36%) patients had para-aortic lymph node metastasis. When pelvic lymph nodes had metastases, the para-aortic lymph node simultaneous metastasis rate was 30.00% (36/120). The risk of isolated para-aortic lymph node metastasis was 0.42% (1/237). There were no significant differences in the survival outcomes between the para-aortic lymph node unresected and resected groups. No differences in the survival outcomes were found before or after matching between the two groups regardless of pelvic lymph node negativity/positivity.

CONCLUSION:

Para-aortic lymphadenectomy did not improve 5-year survival outcomes in surgical patients with stage IB1-IIA2 cervical cancer. Therefore, when pelvic lymph node metastasis is negative, the risk of isolated para-aortic lymph node metastasis is very low, and para-aortic lymphadenectomy is not recommended. When pelvic lymph node metastasis is positive, para-aortic lymphadenectomy should be carefully selected because of the high risk of this procedure.

• Authors: Chunlin Chen, Hui Duan, Wenling Zhang, Hongwei Zhao, Li Wang, Shan Kang, Lihong Lin, Weidong Zhao, Yan Ni, Donglin Li, Jiaming Chen, Huijian Fan, Xiaolin Chen, Xiaonong Bin, Jinghe Lang, Ping Liu
• Journal: BMC cancer (BMC Cancer) Vol. 21 Issue 1 Pg. 1091 (Oct 09 2021) ISSN: 1471-2407 [Electronic] England
• PMID: 34627169 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: © 2021. The Author(s).

Topics

• Case-Control Studies
• China
• Female
• Follow-Up Studies
• Humans
• Hysterectomy (methods, mortality, statistics & numerical data)
• Lymph Node Excision (mortality, statistics & numerical data)
• Lymphatic Metastasis
• Middle Aged
• Pelvis
• Retrospective Studies
• Survival Analysis
• Uterine Cervical Neoplasms (mortality, pathology, surgery)