Evaluation and external validation of minor lymphatic pelvic pathway for distant metastases in cervical cancer patients treated with concurrent chemoradiotherapy

To evaluate and validate the minor lymphatic pathway for distant metastases in cervical cancer. This is a retrospective cohort of cervical cancer patients underwent curative concurrent chemoradiotherapy. We used original dataset from 1 university hospital and validation dataset from 3 university hos...

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Published in:Current problems in cancer 2022-08, Vol.46 (4), p.100876-100876, Article 100876
Main Authors: Thephamongkhol, Kullathorn, Korpraphong, Pornpim, Muangsomboon, Kobkun, Sitathanee, Chomporn, Lertkhachonsuk, Arb-aroon, Phongkitkarun, Sith, Srirattanapong, Saowanee, Prapruttam, Duangkamon, Bridhikitti, Jidapa, Dendumrongsup, Thaworn, Alisanant, Petch, Amornwichet, Napapat, Khorprasert, Chonlakiet, Sasiwimonphan, Kewalee, Tanprasertkul, Chamnan, Dhanachai, Mantana, Patumanond, Jayanton, Setakornnukul, Jiraporn
Format: Article
Language:English
Subjects:
Cervical cancer
Diagnostic imaging
Distant metastasis
Lymphatic vessels
Lymphatic-venous direct connection
Neoplasm staging
Prognosis
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Summary:To evaluate and validate the minor lymphatic pathway for distant metastases in cervical cancer. This is a retrospective cohort of cervical cancer patients underwent curative concurrent chemoradiotherapy. We used original dataset from 1 university hospital and validation dataset from 3 university hospitals. Lymphadenopathy status in CT imaging was reviewed by radiologist in either the obturator and external iliac nodes (major pathway) or the internal iliac and presacral nodes (minor pathway). We then used Cox regression to adjust for all potential confounders, including paraaortic nodes, T stage, histology, age, total treatment time, total number of nodes, total short axis of nodes. 397 and 384 patients were in the original and validation datasets (median follow-up period, 59.5 month’s). The minor pathway was independent prognostic factor in multivariable analysis [HR=2.64; 95%CI=1.07–6.55; P = 0.036] and [HR=14.84; 95%CI=3.15–70.01; P= 0.001] in original and validation datasets, respectively. Whereas, the major pathway was statistically non-significant. Further validation showed that the minor pathway had the highest HR for distant metastases with both the EMBRACE (HR=6.05; 95% CI=1.30–28.08; P = 0.022) and the FIGO 2018 (HR=7.43; 95% CI=2.94–18.78; P
ISSN:0147-0272
1535-6345
DOI:10.1016/j.currproblcancer.2022.100876