Researchers found that measuring the number of lymph nodes (LNs), nodules of white blood cells,  that carry cervical cancer cells (positive LNs) helps to the predict survival time of patients with node-positive early stage cervical cancer.

But they note that the findings apply only to cervical squamous cell carcinoma or adenosquamous carcinoma, and not to cervical adenocarcinoma.

The findings were reported in the study, “Incorporation of the number of positive lymph nodes leads to better prognostic discrimination of node-positive early stage cervical cancer,” published in the journal Oncotarget.

The spread of cancer cells from tumors to nodules of white blood cells, the lymph nodes, is a sign of metastasis, or  cancer that has spread throughout the body. In this research, the goal was to see whether the presence of higher numbers positive LNs predicts survival outcomes in patients with this kind of cervical cancer .

Researchers investigated 2,222 patients with node-positive, early stage cervical cancer, all with positive LNs and who had hysterectomies (surgical removal of the uterus), and their lymph nodes removed (lymphadenectomy). They were divided between two groups: one group had one or two positive lymph nodes, and the other had more than two positive LNs.

Among patients who died of the cancer, those who had 1-2 positive LNs when treatment began survived for longer times than patients with more than 2 positive LNs. The five-year survival rate in the patients who died of the cancer (5-year CSS) was 78.9% in the group with up to two positive LNs, and 65.5% in the group with more than two positive LNs.

But the authors note that the number of positive LNs only had prognostic value in patients with cervical squamous cell carcinoma or adenosquamous carcinoma. No association was seen in patients with cervical adenocarcinoma.

“The number of positive LNs is an independent risk factor for CSS [cause-specific survival] and OS [overall survival] in cervical cancer. This new category might be helpful in better prognostic discrimination of node-positive early stage cervical cancer after hysterectomy,” the researchers wrote. “Further prospective trials are warranted to confirm the value of stratifying patients based on the number of positive LNs.”