Para-aortic lymph node involvement in cervical cancer: Implications for staging, outcome &amp; treatment

Shylasree, TS; Gurram, Lavanya; Das, Ushashree

doi:10.4103/ijmr.ijmr_4183_20

Cited by 1 publication

(1 citation statement)

References 39 publications

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“…The incorporation of nodal involvement in the FIGO 2018 staging definition for cervical cancer highlighted the need for assessing PALN status. 27 In a study involving 618 patients with locally advanced cervical SCC, PALN metastasis was found to be an independent prognostic factor for PFS and OS. 28 In a study involving patients with PALN metastasis, SUV max of the involved PALN metastasis and nodal volume or total lesion glycolysis were used to stratify patients in terms of survival.…”

Section: Discussionmentioning

confidence: 99%

Clinical factor‐based risk stratification for precision therapy in locally advanced squamous cell carcinoma of the uterine cervix

Liu,

Chen,

Pan

et al. 2024

Cancer Medicine

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BackgroundConcurrent chemoradiotherapy (CCRT) is the standard of care for locally advanced cervical cancer. In this study, we analyzed the pretreatment clinical and 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) characteristics of patients with locally advanced cervical squamous cell carcinoma (SCC) to develop a scoring prototype for risk stratification.MethodsTwo cohorts were constructed in this study. Cohort 1 comprised patients with cervical SCC with 2009 FIGO stage III‐IVA or stage I–II with positive pelvic or para‐aortic lymph node (PALN) on PET/CT from AGOG09‐001 trial. Cohort 2 comprised patients with similar characteristics who had received adequate therapy in our hospital between 2016 and 2021. Pretreatment patient characteristics and PET/CT parameters including maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of primary tumor and nodal SUVmax were assessed for cancer‐specific survival (CSS) using multivariate Cox regression.ResultsAnalysis of combined data from cohorts 1 (n = 55) and 2 (n = 128) indicated age ≥ 66 years, primary tumor MTV ≥87 mL, and positive PALN on PET/CT to be independently significant adverse predictors for CSS (p < 0.001, p = 0.014, and p = 0.026, respectively) with a median follow‐up duration of 51 months. Assigning a score of 1 to each adverse predictor, patients with cumulative risk scores of 0, 1, 2, and 3 were discovered to have a 5‐year CSS of 86.9%, 71.0%, 32.2%, and 0%, respectively (p < 0.001).ConclusionAge, primary tumor MTV, and positive PALN on PET/CT may serve as independent predictors of poor survival in patients with locally advanced cervical SCC. Our findings indicate that patients without any adverse factors can receive standard CCRT, whereas those with at least one adverse factor can consider novel combination therapies or clinical trials.

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Section: Discussionmentioning

confidence: 99%