Objective: The purpose of this study was to determine the significance of the positive pelvic lymph node (PLN) metastasis on progression-free survival (PFS) and overall survival (OS) of early cervical cancer patients. The values of other known poor prognostic factors were also analyzed for prediction of the disease prognosis.
Methods: The stage 1A-IIA cervical cancer patients from 1998 to 2014 who underwent radical surgery were retrospectively reviewed. Parameters such as age, FIGO stage, histologic type, tumor size, depth of stromal invasion, PLN metastasis, the number of the PLN metastasis, LVSI, parametrial invasion, vaginal resection margin status were collected then the PFS and OS were evaluated.
Results: In univariate analysis, tumor stage, tumor size, stromal invasion, the number of PLN metastasis and LVSI were significantly associated with both PFS and OS. The multivariate analysis showed that the size (P=0.0198), the number of PLN metastasis (P=0.0005) and the LVSI (P=0.0429) had significant association with PFS. Regarding OS, the number of PLN metastasis (P=0.0044) and stromal invasion (P=0.0427) were significantly associated.
Conclusion: Tumor size, number of PLN metastasis and LVSI had significant association with PFS and stromal invasion and number of PLN metastasis were also significantly associated with OS in multivariate analysis. Among poor prognostic factors, the number of PLN metastasis is one of the most important prognostic factor, therefore it is important to confirm LN metastasis status after radical surgery.