The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors: A multicenter cohort study (krog 15-04)

Jeanny Kwon, Keun Yong Eom, Young Seok Kim, Won Park, Mison Chun, Jihae Lee, Yong Bae Kim, Won Sup Yoon, Jin Hee Kim, Jin Hwa Choi, Sei Kyung Chang, Bae Kwon Jeong, Seok Ho Lee, Jihye Cha

Research output: Contribution to journalArticle

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Abstract

Purpose We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. Materials and Methods A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pN stage, number of mPLN, lymph node (LN) ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). Results In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ -0.58 vs. > -0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). Conclusion mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

Original languageEnglish
Pages (from-to)964-974
Number of pages11
JournalCancer Research and Treatment
Volume50
Issue number3
DOIs
StatePublished - 1 Jul 2018

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Uterine Cervical Neoplasms
Multicenter Studies
Cohort Studies
Lymph Nodes
Recurrence
Disease-Free Survival
Neoplasm Metastasis
Carcinoma
Survival
Chemoradiotherapy
Squamous Cell Carcinoma
Histology
Multivariate Analysis
Retrospective Studies

Keywords

  • Adjuvant treatment
  • Combined modality therapy
  • Lymphatic metastasis
  • Scoring system
  • Uterine cervical neoplasms

Cite this

Kwon, Jeanny ; Eom, Keun Yong ; Kim, Young Seok ; Park, Won ; Chun, Mison ; Lee, Jihae ; Kim, Yong Bae ; Yoon, Won Sup ; Kim, Jin Hee ; Choi, Jin Hwa ; Chang, Sei Kyung ; Jeong, Bae Kwon ; Lee, Seok Ho ; Cha, Jihye. / The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors : A multicenter cohort study (krog 15-04). In: Cancer Research and Treatment. 2018 ; Vol. 50, No. 3. pp. 964-974.
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title = "The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors: A multicenter cohort study (krog 15-04)",
abstract = "Purpose We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. Materials and Methods A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pN stage, number of mPLN, lymph node (LN) ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). Results In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17{\%} vs. > 17{\%}), and log odds of mPLNs (≤ -0.58 vs. > -0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). Conclusion mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.",
keywords = "Adjuvant treatment, Combined modality therapy, Lymphatic metastasis, Scoring system, Uterine cervical neoplasms",
author = "Jeanny Kwon and Eom, {Keun Yong} and Kim, {Young Seok} and Won Park and Mison Chun and Jihae Lee and Kim, {Yong Bae} and Yoon, {Won Sup} and Kim, {Jin Hee} and Choi, {Jin Hwa} and Chang, {Sei Kyung} and Jeong, {Bae Kwon} and Lee, {Seok Ho} and Jihye Cha",
year = "2018",
month = "7",
day = "1",
doi = "10.4143/crt.2017.346",
language = "English",
volume = "50",
pages = "964--974",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Cancer Association",
number = "3",

}

The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors : A multicenter cohort study (krog 15-04). / Kwon, Jeanny; Eom, Keun Yong; Kim, Young Seok; Park, Won; Chun, Mison; Lee, Jihae; Kim, Yong Bae; Yoon, Won Sup; Kim, Jin Hee; Choi, Jin Hwa; Chang, Sei Kyung; Jeong, Bae Kwon; Lee, Seok Ho; Cha, Jihye.

In: Cancer Research and Treatment, Vol. 50, No. 3, 01.07.2018, p. 964-974.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors

T2 - A multicenter cohort study (krog 15-04)

AU - Kwon, Jeanny

AU - Eom, Keun Yong

AU - Kim, Young Seok

AU - Park, Won

AU - Chun, Mison

AU - Lee, Jihae

AU - Kim, Yong Bae

AU - Yoon, Won Sup

AU - Kim, Jin Hee

AU - Choi, Jin Hwa

AU - Chang, Sei Kyung

AU - Jeong, Bae Kwon

AU - Lee, Seok Ho

AU - Cha, Jihye

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Purpose We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. Materials and Methods A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pN stage, number of mPLN, lymph node (LN) ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). Results In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ -0.58 vs. > -0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). Conclusion mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

AB - Purpose We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. Materials and Methods A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pN stage, number of mPLN, lymph node (LN) ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). Results In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ -0.58 vs. > -0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). Conclusion mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

KW - Adjuvant treatment

KW - Combined modality therapy

KW - Lymphatic metastasis

KW - Scoring system

KW - Uterine cervical neoplasms

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U2 - 10.4143/crt.2017.346

DO - 10.4143/crt.2017.346

M3 - Article

C2 - 29081219

AN - SCOPUS:85048479772

VL - 50

SP - 964

EP - 974

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 3

ER -