Monographic Research·Advances Regarding Lymphadenectomy in Gynecologic Malignancies
The clinical analysis of lymph node metastasis features and clinical factors in early stage cervix carcinoma
Wang Jun, Tian Weijie, Ding Yani, Gong Yuan, Zhang Xiaolei, Gao Yan, Liu Zhijun, Zhang Huimin, Li Donglin
Published 2021-02-20
Cite as J Chin Physician, 2021, 23(2): 189-192. DOI: 10.3760/cma.j.cn431274-20201230-01765
Abstract
ObjectiveTo explore the distribution of pelvic lymph node (PLN) metastasis and the correlative dangerous factors in early cervical cancer patients.
MethodsThe medical records of 508 patients who underwent extensive hysterectomy and lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰb-Ⅱb cervical cancer in Guizhou Provincial People`s Hospital were reviewed retrospectively.
ResultsThere were 278 patients with stage Ⅰb cervical cancer, 204 patients with stage Ⅱa cervical cancer and 26 patients with stage Ⅱb cervical cancer; the positive rate of lymph node metastasis was 16.7%(85/508), and obturator lymph node metastasis was the most common (56.6%); there were 19 patients with bilateral lymph node metastasis, accounting for 22.35%(19/85); lymph node metastasis occurred 104 times (two times for bilateral simultaneous transfer), and jumping lymph node metastasis accounted for 37.5%(39/104); common iliac lymph node metastasis accounted for 18.3%(19/104). The metastasis rate of patients with stage Ⅱa and Ⅱb (including parametrial, lymph node, ovarian and oviduct metastasis) was higher than that of patients with stage Ⅰb, and the odd ratio (OR) was 2.30 and 2.48 respectively (P<0.05); the metastasis rate of patients with moderately differentiated tumors was significantly higher than that of patients with well differentiated and poorly differentiated tumors (P<0.05). There was no significant difference in the positive rate of pelvic lymph node metastasis among patients with different ages and histological types (P>0.05); the positive rate of pelvic lymph node metastasis in patients with stage Ⅱa and Ⅱb was higher than that in patients with stage Ⅰb with statistically significant difference (P<0.05); the positive rate of pelvic lymph node metastasis in patients with moderately differentiated tumors was higher than that in patients with well differentiated and poorly differentiated tumors, with statistically significant difference (P<0.05).
ConclusionsObturator lymph node metastasis is the most common in cervical cancer. The risk of lymph node metastasis is increased in patients with stage Ⅱa or moderately differentiated tumors. Jumping metastasis is also a common way of metastasis, which suggests that standard and complete lymph node resection is an important measure to ensure the curative effect.
Key words:
Uterine cervical neoplasms; Hysterectomy; Lymphatic metastasis
Contributor Information
Wang Jun
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Tian Weijie
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Ding Yani
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Gong Yuan
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Zhang Xiaolei
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Gao Yan
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Liu Zhijun
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Zhang Huimin
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
Li Donglin
Department of Obstetrics and Gynecology, Guizhou Provincial People′s Hospital, Guiyang 550002, China
