TITLE:
Evaluation of the Risk Factors for Pelvic Lymph Node Metastasis in Early Stage Cervical Cancer
AUTHORS:
J. Ferdous, S. Khatun, S. Akhter, S. Chowdhury, S. Pervin, M. Amir, A. Goodman
KEYWORDS:
Cervical Cancer, Lymph Node Metastases, Inflammation
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.12,
December
27,
2018
ABSTRACT: Objective: This study evaluated the risk factors for pelvic
lymph node metastasis in patients with early stage cervical cancer. Material
and Methods: A cross sectional study was carried out in the Division of
Gynaecologic Oncology at Bangabandhu Sheikh Mujib Medical University (BSMMU)
between July 2014 and July 2015 to evaluate demographic factors and
histopathological findings of women with cervical cancer stage IB-IIA who
underwent primary radical hysterectomy and bilateral pelvic lymph node
dissection. Results: Fifty
women aged 30 years or above were included in the study. Lymph node metastases
were identified in 20% of patients. By univariate analysis, preoperative
anemia, a history of smoking, tumor size greater than 4 cm and lack of cervical
inflammatory reaction by histopathology were significant variables associated
with lymph node metastasis. Multivariate analysis showed that the lack of
inflammatory reaction in the uterine cervix was the most important predictor
for pelvic lymph node metastasis when adjusting for other variables. Moderate
to severe inflammatory reaction in the uterine cervix was 18 times less likely
to have pelvic lymph node metastasis than those who had mild inflammation. Conclusion: An association was found between the presence of pelvic lymph node
metastasis in cervical cancer and certain variables: the lack of contraceptive
use, smoking, preoperative anemia, bulky tumors, invasion of deep two-third of
the uterine cervix, mild inflammatory reaction in the cervix, and keratinizing
carcinoma. After adjusting for other factors, presence or absence of
inflammatory reaction in the cervix was found to be the most important
predictor for pelvic lymph node metastasis.