The Potential Effect Of The Number Of Surgically Removed Lymph Nodes On The Survival Of Patients With Stage â… A2-â…¡B1 Cervical Squamous Cell Carcinoma

Objective: To testify the potential effect of patients’ number of surgically removed lymph nodes upon the survival of patients with stage ⅠA2-ⅡB1 cervical squmous cell carcinoma in primary surgical treatment(PST) group and neoadjuvant chemotherapy followed by surgery(NCS) group。Methods: Among 1395 patients with cervical squamous cell carcinoma(SCC)admitted to our hospital during Jan 2010 and Jan 2015,206 cases with stage ⅠA2-ⅡA1 who underwent primary surgery, and 515 cases with stage ⅠB2-ⅡB1 who underwent neoadjuvant chemotherapy followed by surgery were selected. Progression-free survival(PFS) was calculated as the primary outcome measure. Kaplan-Meier curve and Cox regression model were used to analyze the effect of the number of removed lymph nodes(RLN) and metastatic lymph node(MLN) upon PFS.Results: 1. Clinical pathological features demonstrated differential FIGO stage and lymph nodes state between PST and NCS group. 2. The advantage of more RLN(≥19,P=0.049) or less MLN( < 2,P<0.001) to improve PFS was found in NCS group. Moreover, those patients with MLN ≥2 in NCS group might benefit from thoroughly removing lymph node(RLN≥19,P=0.038). However, multivariate analysis revealed metastatic lymph node(P<0.001) and resection margin state(P<0.001) were independent prognostic factors for survival.Conclusions: For stage ⅠB2-ⅡB1 SCC patients who underwent surgery following neoadjuvant chemotherapy, systemic lymphadnectomy might improve the survival of those with MLN.