Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
| Autor: | Kidong Kim, Jae Sung Kim, Keun Yong Eom, Young Beom Kim, Jeanny Kwon, In Ah Kim, Jae Hong No |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Uterine cervical neoplasms Log odds medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Internal medicine Log odds of positive lymph node mental disorders Humans Medicine Radical surgery Lymph nodes Neoplasm Staging Cervical cancer 030219 obstetrics & reproductive medicine business.industry Prognosis medicine.disease Lymphatic Metastasis 030220 oncology & carcinogenesis Female Radiotherapy Adjuvant Original Article Lymph business Value (mathematics) Adjuvant |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2015.085 |
| Popis: | Purpose The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment. Materials and Methods Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. Results The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). Conclusion LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF. |
| Databáze: | OpenAIRE |
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