Erken evre serviks kanseri hastalarında lenf nodunu metastazını predikte eden faktörler

Öz

Amaç: Serviks kanseri hastalarında lenf nodu metastazının (LNM) değerlendirmesi tedavinin bireyselleştirilmesi için önemli bir konudur. Çalışmamızın amacı, serviks kanserli hastalarda LNM'nin prediktif faktörlerini belirlemektir. Gereç ve Yöntem: Bu retrospektif çalışmaya, 2007'den 2019'a kadar Uluslararası Jinekoloji ve Obstetrik Federasyonu (FIGO) evre IB1-IIA2'nin serviks kanseri hastaları dahil edildi. LNM insidanslarıyla beraber tek ve çok değişkenli modellerde pelvik ve paraaortik LNM için risk faktörlerinin prediktif değeri belirlendi. Bulgular: Çalışmaya dahil edilen 212 hastadan pelvik LNM olan hasta sayısı 81(%38.2), paraaortik LNM'li hasta sayısı 17(%8) idi. Serviks kanseri hastalarında multivariyant analize göre parametriyal tutulum (hazard ratio [HR]: 2.75, 95% confidence interval [CI], 1.18-6.40, p=0.019) ve lenfovasküler tutulum ([HR]: 3.83, 95% [CI], 1.76-8.38, p=0.001) pelvik LNM için bağımsız risk faktörleriydi iken paraaortik LNM için parametriyal tutulum bağımsız risk faktörüydü ([HR]: 3.62, 95% [CI], 1.20-10.98, p=0.023). Sonuç: Serviks kanseri hastalarında pelvik LNM'nin prediktif faktörleri parametrial tutulum ve LVSI iken paraaortik LNM için prediktif risk faktörü parametrial tutulumdu.

Anahtar Kelimeler

• Serviks kanseri
• lenf nodu metastazı
• risk faktörleri

Predictors of lymph node metastasis in early-stage cervical cancer

Öz

Purpose: An accurate assessment of a potential lymph node metastasis (LNM) is an important issue for the individual treatment of cervical cancer. The goal of the current retrospective study was to identify predictive factors of LNM in patients with cervical cancer. Materials and Methods: In this retrospective study, from 2007 to 2019, patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA2 were included. Incidences of LNM were described, and the predictive value of the risk factors for pelvic and paraaortic LNM were determined in univariate and multivariate models. Results: Among 212 patients, the number of patients with pelvic LNM was 81(38.2%), the number of patients with paraaortic LNM was 17(8%). Multivariate analysis revealed that the parametrial involvement (hazard ratio [HR]: 2.75, 95% confidence interval [CI], 1.18-6.40, p=0.019) and LVSI ([HR]: 3.83, 95% [CI], 1.76-8.38, p=0.001) were independent risk factors for pelvic LNM with cervical cancer patients. For paraaortic LNM parametrial involvement was independent risk factor on multivariate analysis ([HR]: 3.62, 95% [CI], 1.20-10.98, p=0.023). Conclusion: The predictive factors of pelvic LNM in cervical cancer patients were parametrial involvement and LVSI and for paraaortic LNM was parametrial involvement.

Anahtar Kelimeler

• Serviks kanseri
• lenf nodu metastazı
• risk faktörleri

Kaynakça

1. 1. Takekuma M, Kasamatsu Y, Kado N, Kuji S, Tanaka A, Takahashi N, et al. The issues regarding postoperative adjuvant therapy and prognostic risk factors for patients with stage I–II cervical cancer: a review. Journal of Obstetrics and Gynaecology Research. 2017;43(4):617-26.
2. 2. Scheidler J, Hricak H, Kyle KY, Subak L, Segal MR. Radiological evaluation of lymph node metastases in patients with cervical cancer: a meta-analysis. Jama. 1997;278(13):1096-101.
3. 3. Selman TJ, Mann C, Zamora J, Appleyard T-L, Khan K. Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. Cmaj. 2008;178(7):855-62.