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International Journal of Clinical Oncology

Published in:

01-04-2016 | Original Article

Radical hysterectomy with or without para-aortic lymphadenectomy for patients with stage IB2, IIA2, and IIB cervical cancer: outcomes for a series of 308 patients

Authors: Tetsushi Tsuruga, Asaha Fujimoto, Kei Kawana, Mayuyo Mori, Yoko Hasumi, Nao Kino, Kensuke Tomio, Shiho Miura, Michihiro Tanikawa, Kenbun Sone, Yuichiro Miyamoto, Yuji Ikeda, Satoko Kojima, Katsuyuki Adachi, Kazunori Nagasaka, Yoko Matsumoto, Takahide Arimoto, Katsutoshi Oda, Shunsuke Nakagawa, Koji Horie, Toshiharu Yasugi, Harushige Yokota, Yutaka Osuga, Tomoyuki Fujii

Published in: International Journal of Clinical Oncology | Issue 2/2016

Abstract

Background

Although many studies have already shown that lymph node metastasis is one of the major prognostic factors for cervical cancer, the therapeutic significance of para-aortic lymphadenectomy for the surgical treatment of cervical cancer remains controversial.

Methods

A total of 308 patients diagnosed with stage IB2, IIA2, or IIB cervical cancer and treated with radical hysterectomy were retrospectively investigated to assess the incidence of para-aortic lymph node metastasis and the clinicopathological factors linked to cervical cancer prognosis.

Results

Para-aortic lymph node metastases were pathologically confirmed in 13 of the 136 patients (9.6 %) who underwent para-aortic lymphadenectomy. The incidence of para-aortic lymph node metastasis was significantly higher in the patients who had common iliac lymph node metastases (odds ratio 31.5, p < 0.001) according to logistic regression analysis. Common iliac lymph node metastasis was related to risk of recurrence (hazard ratio 2.43, p = 0.003) and death (hazard ratio 2.62, p = 0.007) in Cox regression analysis. Kaplan–Meier analysis and Cox regression analysis showed that para-aortic lymphadenectomy did not have a positive impact on survival in 308 patients or 140 pN1 patients, but para-aortic lymphadenectomy was related to better overall survival with a marginal trend toward significance (p = 0.053) in 30 patients with common iliac lymph node metastasis.

Conclusions

Indication for para-aortic lymphadenectomy in the surgical treatment of stage IB2, IIA2, or IIB cervical cancer needs to be individualized. Patients with common iliac lymph node metastasis are possible candidates, and a prospective study is needed to clarify this issue.

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Title: Radical hysterectomy with or without para-aortic lymphadenectomy for patients with stage IB2, IIA2, and IIB cervical cancer: outcomes for a series of 308 patients
Authors: Tetsushi Tsuruga
Asaha Fujimoto
Kei Kawana
Mayuyo Mori
Yoko Hasumi
Nao Kino
Kensuke Tomio
Shiho Miura
Michihiro Tanikawa
Kenbun Sone
Yuichiro Miyamoto
Yuji Ikeda
Satoko Kojima
Katsuyuki Adachi
Kazunori Nagasaka
Yoko Matsumoto
Takahide Arimoto
Katsutoshi Oda
Shunsuke Nakagawa
Koji Horie
Toshiharu Yasugi
Harushige Yokota
Yutaka Osuga
Tomoyuki Fujii
Publication date: 01-04-2016
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 2/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-015-0907-3

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