[Relationship between metastasis in the para-aortic lymph nodes of cervical cancer and pathological features]

Objective: To investigate the incidence and the related risk factors of para-aortic lymph node metastasis in cervical cancer. Methods: The pathological data of 727 patients with cervical cancer who underwent radical hysterectomy and pelvic and para-aortic lymph node dissection were retrospectively analyzed. The relative postoperative pathological parameters of para-aortic lymph node metastasis were statistically analyzed. Results: Among the 727 patients with cervical cancer, 123(16.9%) had para-aortic lymph node metastasis. Univariate analysis showed that the tumor size, the depth of muscular invasion, the vessel invasion, the uterine body invasion, the vaginal invasion, the parametrial invasion, positive surgical margin, the ovary metastasis, the fallopian tubes metastasis, the pelvic lymph node metastasis, and the common iliac lymph node metastasis were associated with para-aortic lymph node metastasis. While the multivariate logistic regression analysis showed that the diameter of primary tumor >4.2 cm, the parametrial invasion, the pelvic lymph node metastasis, and the common iliac lymph node metastasis were the independent risk factors of para-aortic lymph node metastasis. Conclusions: The diameter of primary tumor >4.2 cm, the parametrial invasion, the pelvic lymph node metastasis, and the common iliac lymph node metastasis are the independent risk factors of para-aortic lymph node metastasis in cervical cancer. The tumor size and the common iliac lymph node status should be fully evaluated before the initial operation. Additionally, assessment of the postoperative pelvic lymph node status and the parametrial status will help reduce the rate of misdiagnosis and missed diagnosis, providing a basis for individualized treatment and prognostic judgment.