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- W4230763735 abstract "Lymph 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. We analyzed 78 patients with locally advanced cervical cancer that underwent complete paraaortic lymphadenectomy. Fifteen (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. Patients 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. Las metástasis linfáticas son el factor pronóstico más importante en el cáncer de cérvix localmente avanzado. La linfadenectomía paraaórtica es el único método capaz de confirmar la presencia de metástasis y, por lo tanto, ayudar a determinar el enfoque de tratamiento más adecuado. No existe una norma con respecto al número mínimo de ganglios que deben resecarse en la linfadenectomía paraaórtica. Las mujeres con ganglios paraaórticos positivos no diagnosticados (falsos negativos) debido a un bajo recuento no reciben radioterapia de campo extendido, lo que puede conducir a peores resultados de supervivencia. El objetivo de este estudio es confirmar las metástasis ganglionares como principal factor pronóstico y evaluar si, en los casos de cáncer de cérvix localmente avanzado sin metástasis ganglionares paraaórticas, el número de ganglios extraídos por laparoscopia tiene un valor pronóstico. Se analizaron 78 pacientes con cáncer cervical localmente avanzado que se sometieron a una linfadenectomía paraaórtica completa. Quince (19,2%) mujeres tuvieron metástasis ganglionares paraaórticas. El número medio de ganglios extraído fue de 11,1 (DE 7,5). Las pacientes con metástasis paraaórticas presentaron una peor supervivencia global (127,1 meses [IC del 95%: 111,7-142,4] frente a 59,6 meses [IC del 95%: 31,2 a 87,9]; p < 0,01). Sin embargo, no hubo diferencias en cuanto a la supervivencia libre de enfermedad. No hubo diferencias pronósticas según el número de ganglios resecados en pacientes con linfadenectomía negativa. Las pacientes con cáncer cervical localmente avanzado y metástasis paraaórticas presentan peor supervivencia. En las mujeres con linfadenectomía paraaórtica negativa, el número de ganglios extraídos no implica una supervivencia peor." @default.
- W4230763735 created "2022-05-11" @default.
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- W4230763735 date "2020-09-01" @default.
- W4230763735 modified "2023-10-18" @default.
- W4230763735 title "Number of paraaortic lymph node dissections as a prognostic factor in locally advanced cervical cancer" @default.
- W4230763735 doi "https://doi.org/10.1016/j.medcle.2019.11.011" @default.
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