The relationship between lymph node status and prognosis in patients with cervical cancer

Objective To analyze the features of lymph node metastasis and their influences on prognosis of patients with cervical cancer.Methods A retrospective analysis was made in 311 patients with cervical cancer treated by surgery.Number,location,size and pathological findings of removed lymph nodes were recorded,and 5-year survival situations of all patients were followed-up.Results(1) The lymph node metastasis rate of all studied patients was 23.8%(74/311),and it was up to 62.2%(46/74) at obturator.The lymph node metastasis pathway mainly passed along the parametrial lymph nodes to obturator,iliac or external iliac,common iliac lymph nodes,perirectal lymph node,and then to the abdominal aortic lymph node.Three cases was skip metastasis.(2) In the multivariate analysis of prognostic factors,5-year survival rates in patients with or without lymph node metastasis were 54.5% and 86.1% respectively(P0.01).(3) The risk ratios of the number and stations of lymph node metastasis were 2.441(95% CI:1.464-4.069) and 2.484(95% CI:1.119-5.517) respectively;5-year survival rates in patients with metastatic lymph node number≤3,4-10,10 were 80.0%,57.6% and 22.5% respectively(P0.01);5-year survival rates of patients with single station lymph node metastasis and multiple lymph node metastasis were 72.0% and 43.1% respectively(P0.05).Conclusions Lymph node metastasis of cervical cancer always passes along the lymphatic drainage pathways,and obturator lymph node metastasis is most common found.Lymph node status is an important affecting factor of the prognosis.The more of the lymph nodes metastasis number,the worse prognosis of the patients.