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Should all cervical cancer patients with positive lymph node receive definitive radiotherapy: a population-based comparative study

  • 0Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44, Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, People's Republic of China.
Archives of Gynecology and Obstetrics +

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January 3, 2025

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January 3, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

For cervical cancer with lymph node metastases (LNM), surgery plus postoperative radiotherapy (PORT) improves survival in early stages (I-II) or limited lymph node spread (≤5). This benefit is not seen in advanced stages (III) or extensive lymph node involvement (>5).

Area Of Science

  • Gynecologic Oncology
  • Radiation Oncology
  • Surgical Oncology

Background

  • Optimal management for cervical cancer with lymph node metastases (LNM) is debated.
  • Treatment strategies include surgery with postoperative radiotherapy (PORT) versus definitive radiotherapy (RT).

Purpose Of The Study

  • To compare the survival outcomes of surgery plus PORT versus definitive RT in cervical cancer patients with LNM.
  • To identify patient subgroups benefiting from specific treatment modalities.

Main Methods

  • Retrospective analysis of 2936 patients with positive lymph nodes (PLNs) from the 2009 FIGO stage I-III cervical cancer cohort in the SEER database.
  • Kaplan-Meier, log-rank, Cox, and interaction analyses were used to assess survival outcomes and treatment benefits.

Main Results

  • Primary treatment choice significantly impacted cancer-specific survival (CSS) and overall survival (OS).
  • Surgery plus PORT showed improved CSS and OS in stage I-II and PLNs ≤ 5 subgroups.
  • No significant survival difference was found between treatments for stage III or PLNs > 5 subgroups.

Conclusions

  • Surgery plus PORT offers improved outcomes for cervical cancer patients with stage I-II or ≤ 5 positive lymph nodes.
  • This approach is not superior for stage III or > 5 positive lymph nodes.
  • Treatment decisions for LNM should consider comprehensive assessment of lymph node burden and tumor spread.

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