One biological factor that is valuable in predicting the outcome of a patients’ cervical cancer is pelvic lymph node metastasis (LNM). Whether or not lymph nodes are invaded by metastatic cervical cancer has a profound impact on the survival of a patient. It is known that LNM occurs in approximately 15-25% of patients with Stage IB-IIA cervical cancer, and that LNM can reduce five-year survival rates from 80% to 53%, but an understanding of how different features of LNM can further affect survival and recurrence of cervical cancer is still necessary.
A team of researchers in the Department of Obstetrics and Gynecology at Peking University People’s Hospital in Beijing conducted a review of State IA-IIB cervical cancer patient data to evaluate how ten different clinicopathological variables can be predictive of developing pelvic LNM. “Pelvic LNM is an important prognostic factor in cervical cancer,” stated the authors. The researchers reviewed nearly 300 patients for age at diagnosis, number of pregnancies, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI), depth of cervical stromal invasion, uterine invasion, parametrial invasion, and use of neoadjuvant chemotherapy.
As reported by the article, “The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma,” which was published in Chinese Medical Journal, 20% of patients in the study cohort had pelvic LNM. This agreed with the previous statistic of LNM prevalence in cervical cancer. When looking at these patients, the researchers noted that they were more likely to experience recurrence following treatment.
Survival was reduced even more in patients with LNM if they had multiple lymph nodes positive for invasion. Additionally, having multiple groups–rather than a single group–of positive lymph nodes contributed to poorer survival.
From the variables tested to determine the effects of developing LNM, only LVSI, parametrial invasion, and depth of cervical stromal invasion could independently predict the development of LNM. Using this knowledge, a patient who demonstrates one or more of these variables should be on the lookout for LNM and receive the appropriate treatment to reduce the effects on their survival.