Analysis of Lymph Node Metastasis and Risk Factors in 975 Patients with FIGO 2009 Stage ⅠA-ⅡA Cervical Cancer

Abstract

Objective To summarize the lymph node metastasis (LNM) rate of patients with stage ⅠA-ⅡA cervical cancer, and further analyze its distribution characteristics and related risk factors. Methods According to FIGO 2009, the clinical data of 975 patients with stage ⅠA-ⅡA cervical cancer treated in our hospital from January 2010 to December 2018 were retrospectively analyzed. The incidence and distribution of LNM were analyzed, and the influencing factors of cervical cancer LNM were analyzed by univariate and multivariate Logistic regression. Results In this study, the LNM rate was 14.8%(144/975), and a total of 20288 lymph nodes were removed, among which 359 lymph nodes had metastasis. According to the statistics of the number and frequency of metastatic lymph nodes in different regions, the metastatic rate was the highest in the parauterine/obturator regions. Univariate analysis showed that pregnancy > 3 times, tumor size > 4cm, gross type, FIGO stage, pathological type, positive lymphovascular space invasion (LVSI), deep cervical stromal invasion (outer 1/2 invasion), parametrial involvement and uterine corpus invasion (UCI) were all correlated with LNM (P <0.05). Multivariate analysis showed tumor lesion >4cm (OR=2.253,95%CI:1.486-3.416,P<0.001), positive LVSI (OR=5.353,95%CI: 3.303-8.676, P <0.001), deep cervical stromal invasion (OR=3.461, 95%CI: 2.106-5.688, P<0.001)and deep UCI (myometrial invasion≥50%) (OR=3.529, 95%CI: 1.321-9.427, P=0.012)were independent risk factors for LNM. Conclusion C ervical cancer patients are more likely to have LNM if the tumor size > 4cm, positive LVSI, deep cervical stromal invasion and deep UCI. In clinical treatment, attention should be paid to the evaluation of LNM.