• Medicina clinica · Sep 2020

    Number of paraaortic lymph node dissections as a prognostic factor in locally advanced cervical cancer.

    • Inmaculada Nicolás, Juan Gilabert-Estellés, Juan Gilabert-Aguilar, Pere Fusté, Kristina Aghababyan, Jaume Pahisa, Blanca Gil-Ibañez, Berta Díaz-Feijoo, Francisco Carmona, Francisco Javier Calpe, Adela Saco, Jaume Ordi, and Aureli Torne.
    • Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. Electronic address: inicolas@clinic.cat.
    • Med Clin (Barc). 2020 Sep 11; 155 (5): 197-201.

    BackgroundLymph node (LN) metastases are the most important prognostic factor in locally advanced cervical cancer. Paraaortic lymphadenectomy is the only method able to confirm the presence of metastasis and thereby help to determine the most adequate treatment approach. There is no standard regarding the minimal number of LNs that should be removed in paraaortic lymphadenectomy. Women with undiagnosed positive paraaortic LNs (false negatives) due to a low LN count do not receive extended-field radiation therapy, which may lead to worse survival outcomes. The aim of this study is to confirm LN metastases as poor prognosis and to assess whether in cases of locally advanced CC with negative paraaortic LN status, the number of paraaortic LN laparoscopically removed carries a prognostic value.MethodsWe analyzed 78 patients with locally advanced cervical cancer that underwent complete paraaortic lymphadenectomy.ResultsFifteen (19.2%) women had paraaortic LN metastases. The mean number of LN extracted was 11.1 (SD 7.5). Patients with paraaortic LN metastases presented a worse overall survival (127.1 months [95% CI 111.7-142.4] vs. 59.6 months [95% CI 31.2-87.9]; p<0.01). Nevertheless, there were no differences regarding disease-free survival. There were no prognostic differences according to the number of LNs resected in patients with negative lymphadenectomy.ConclusionsPatients with locally advanced cervical cancer and paraaortic LN metastases present worse survival. In women with negative paraaortic LN, the number of LNs removed does not imply shorter survival.Copyright © 2019 Elsevier España, S.L.U. All rights reserved.

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