Para-Aortic Lymph Node Dissection for Patients with Node-Negative Cervical Squamous Cell Carcinoma: A Retrospective Cohort Study

Objective. The current guidelines for cervical cancer are uncertain regarding whether the para-aortic lymph nodes (PALNs) need to be removed. For patients with negative PALNs, whether the addition of PALN dissection (PALND) can be translated into survival benefits is unknown. Methods. The medical re...

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Bibliographic Details
Published in:Journal of oncology 2022-11, Vol.2022, p.1-9
Main Authors: Guo, Qinhao, Zhu, Jun, Wu, Yong, Wu, Jiangchun, Wang, Simin, Wen, Hao, Ju, Xingzhu, Wu, Xiaohua
Format: Article
Language:English
Subjects:
Cancer therapies
Care and treatment
Cellular biology
Cervical cancer
Cohort analysis
Confounding (Statistics)
Dissection
Gynecology
Lymphatic system
Medical prognosis
Medical records
Metastasis
Pathology
Patients
Squamous cell carcinoma
Surgery
Surgical outcomes
Vagina
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Summary:Objective. The current guidelines for cervical cancer are uncertain regarding whether the para-aortic lymph nodes (PALNs) need to be removed. For patients with negative PALNs, whether the addition of PALN dissection (PALND) can be translated into survival benefits is unknown. Methods. The medical records of 3,995 patients with FIGO stage IB-IIA cervical squamous cell carcinoma (CSCC) who underwent abdominal radical surgery between 2006 and 2014 at our center were retrospectively reviewed. Two groups were identified: PALN-negative patients who underwent PALND (+PALND) and those who did not (−PALND). The groups were matched by propensity score matching (PSM). Survival was analyzed using the Kaplan–Meier method and the Cox proportional hazards model. Subgroups were stratified by the variables known at the time of diagnosis. Results. After PSM, 313 patients were matched to the −PALND (cohort 1) and +PALND (cohort 2) groups. Cohort 2 patients had a poorer prognosis than cohort 1 patients in terms of overall survival (OS, P=0.014), and PALND was an independent prognostic factor for OS (P=0.021). There were no differences in recurrence patterns between the groups. Subgroup analysis showed that cohort 2 patients had worse OS than cohort 1 patients when they were aged ≤47 years (P=0.033), were premenopausal (P=0.032), were in stage IB (P=0.009), or had preoperative SCC-Ag
ISSN:1687-8450
1687-8450
DOI:10.1155/2022/5025451