The variable impact of positive lymph nodes in cervical cancer: Implications of the new FIGO staging system

2020 ◽  
Vol 156 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Kyra N. McComas ◽  
Anna M. Torgeson ◽  
Bryan J. Ager ◽  
Christopher Hellekson ◽  
Lindsay M. Burt ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Staging System ◽  
Figo Staging ◽  
Variable Impact ◽  
Positive Lymph Nodes

scholarly journals Nomogram to predict overall survival based on the log odds of positive lymph nodes for patients with endometrial carcinosarcoma after surgery

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linzhi Gao ◽  
Jun Lyu ◽  
Xiaoya Luo ◽  
Dong Zhang ◽  
Guifang Jiang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Nodes ◽  
Prediction Model ◽  
Classification System ◽  
Staging System ◽  
Seer Database ◽  
Figo Staging ◽  
Log Odds ◽  
Positive Lymph Nodes ◽  
Better Than

Abstract Purpose Aims to compare the prognostic performance of the number of positive lymph nodes (PLNN), lymph node ratio (LNR) and log odds of metastatic lymph nodes (LODDS) and establish a prognostic nomogram to predict overall survival (OS) rate for patients with endometrial carcinosarcoma (ECS). Methods Patients were retrospectively obtained from Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. The prognostic value of PLNN, LNR and LODDS were assessed. A prediction model for OS was established based on univariate and multivariate analysis of clinical and demographic characteristics of ECS patients. The clinical practical usefulness of the prediction model was valued by decision curve analysis (DCA) through quantifying its net benefits. Results The OS prediction accuracy of LODDS for ECS is better than that of PLNN and LNR. Five factors, age, tumor size, 2009 FIGO, LODDS and peritoneal cytology, were independent prognostic factors of OS. The C-index of the nomogram was 0.743 in the training cohort. The AUCs were 0.740, 0.682 and 0.660 for predicting 1-, 3- and 5-year OS, respectively. The calibration plots and DCA showed good clinical applicability of the nomogram, which is better than 2009 FIGO staging system. These results were verified in the validation cohort. A risk classification system was built that could classify ECS patients into three risk groups. The Kaplan-Meier curves showed that OS in the different groups was accurately differentiated by the risk classification system and performed much better than FIGO 2009. Conclusion Our results indicated that LODDS was an independent prognostic indicator for ECS patients, with better predictive efficiency than PLNN and LNR. A novel prognostic nomogram for predicting the OS rate of ECS patients was established based on the population in the SEER database. Our nomogram based on LODDS has a more accurate and convenient value for predicting the OS of ECS patients than the FIGO staging system alone.

scholarly journals Re-classification of uterine cervical cancer cases treated with radical hysterectomy based on the 2018 FIGO staging system

2021 ◽  
Vol 60 (6) ◽  
pp. 1054-1058
Author(s):  
Daiken Osaku ◽  
Hiroaki Komatsu ◽  
Masayo Okawa ◽  
Yuki Iida ◽  
Shinya Sato ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Staging System ◽  
Uterine Cervical Cancer ◽  
Figo Staging

The prognostic role of horizontal and circumferential tumor extent in cervical cancer: Implications for the 2019 FIGO staging system

2020 ◽  
Vol 158 (2) ◽  
pp. 266-272
Author(s):  
Roman E. Zyla ◽  
Lilian T. Gien ◽  
Danielle Vicus ◽  
Ekaterina Olkhov-Mitsel ◽  
Jelena Mirkovic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Staging System ◽  
Prognostic Role ◽  
Figo Staging ◽  
Tumor Extent

scholarly journals Should the Number of Metastatic Pelvic Lymph Nodes Be Integrated into the 2018 Figo Staging Classification of Early Stage Cervical Cancer?

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1552
Author(s):  
Luigi Pedone Anchora ◽  
Vittoria Carbone ◽  
Valerio Gallotta ◽  
Francesco Fanfani ◽  
Francesco Cosentino ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Early Stage ◽  
Disease Free Survival ◽  
Staging System ◽  
Lymph Node Status ◽  
P Value ◽  
Pelvic Lymph Nodes ◽  
Early Stage Cervical Cancer ◽  
The Impact

Introduction: Lymph node status has become part of the new staging system for cervical cancer (CC). It has been shown that patients staged as IIIC1 had heterogeneous prognoses and, in some cases, experienced better outcomes than patients with lower stages. We evaluated the impact of the number of metastatic pelvic lymph nodes (MPLNs) among patients with stage IIIC1 cervical cancer. Methods: Survival analyses were conducted in order to identify the best cut-off prognostic value relative to the number of MPLNs. Disease free survival (DFS) was considered the main outcome. Results: 541 patients were included in the study. Eighty-nine patients were of stage IIIC1. The best prognostic cut-off value of the number of MPLNs was 2. Patients with >2 MPLNs (n > 2 group) had worse DFS compared with those having <2 (N1-2 group) (5 yr DFS: 54.7% vs. 78.1%, p value = 0.006). Multivariate analyses demonstrated that the extent of MPLNs had little impact on DFS and that replacement of IIIC1 staging with N1-2 and n > 2 grouping provided a better, statistically significant model (p value = 0.006). Discussion: Using a cut-off value of 2, the number of MPLNs could better predict prognostic outcomes within stage IIIC1 cervical cancer and have potential implications for therapeutic decision-making in the treatment of patients with stage IIIC1 CC.

Arguments for a magnetic resonance imaging–assisted FIGO staging system for cervical cancer

2005 ◽  
Vol 15 (4) ◽  
pp. 573-582 ◽  
Author(s):  
K. Narayan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Cancer Biology ◽  
Surgical Techniques ◽  
Staging System ◽  
Combined Modality Treatment ◽  
Resonance Imaging ◽  
Figo Staging ◽  
Patient Selection Criteria

FIGO staging of cervical cancer is based on anatomic compartmental spread of cervical cancer. This was necessary in the evaluation of surgical resectability in each patient. Even if the surgical resection was not deemed satisfactory, surgical findings and subsequent accurate anatomic pathology findings could be used to prescribe tailored adjuvant therapies. Recently, the management of cervical cancer has been influenced by the evidence from several surgical-pathologic studies and phase II and III combined modality treatment trials. However, the patient selection criteria used in these clinical studies were almost always refined by modern medical imaging and surgical techniques not prescribed in the FIGO staging system. The results obtained from these studies would not correlate with those from the patient population similarly treated but selected strictly along the FIGO staging criteria. This selective, heterogenous, and arbitrary refinement of FIGO staging has certainly given insight into cervical cancer biology but in the process has rendered the current FIGO staging of this disease quite inadequate. Prior knowledge of these factors through modern imaging in these patients could be used in staging and selecting the optimum treatment modality while minimizing the treatment-related morbidity. A magnetic resonance imaging-assisted FIGO staging system for cervical cancer as proposed here could be used for selecting patients appropriately for a given treatment package

Preoperative platelet count improves the prognostic prediction of the FIGO staging system for operable cervical cancer patients

2017 ◽  
Vol 473 ◽  
pp. 198-203 ◽  
Author(s):  
Ru-ru Zheng ◽  
Xiao-xiu Huang ◽  
Chu Jin ◽  
Xin-xin Zhuang ◽  
Le-chi Ye ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Platelet Count ◽  
Cancer Patients ◽  
Staging System ◽  
Figo Staging ◽  
Prognostic Prediction

A single-center retrospective analysis to evaluate the prognostic role of lymph node density in patients with lymph node-positive cervical cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17013-e17013
Author(s):  
Arkadius A. Polasik ◽  
Wolfgang Janni ◽  
Christoph Scholz ◽  
Nikolaus De Gregorio ◽  
Fabienne Schochter ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Retrospective Analysis ◽  
Prognostic Role ◽  
Node Density ◽  
Lymph Node Density ◽  
Lymph Node Positive ◽  
Positive Lymph Nodes

e17013 Background: The aim of this retrospective analysis is to evaluate the prognostic role of lymph node density (LND), i.e. the ratio of positive lymph nodes to the total number of lymph nodes removed during surgery, in nodal-positive cervical cancer patients. Methods: Out of 266 patients with cervical cancer that underwent surgery including lymphonodectomy between 2000 and 2017 at the Department for Gynecology and Obstetrics of the University Hospital Ulm, 86 patients with positive lymph nodes were included in the analysis. According to former study results, patients were divided into two groups with LND < 10% vs. ≥ 10%. Univariable and multivariable cox-regression models (adjusted for age, histological subtype, grading, body mass index, R-status, lymphangiosis, histologically confirmed FIGO-status and chemotherapy) were used to evaluate the association between LND and both overall survival (OS) and disease-free survival (DFS). Results: In the 86 patients, a median of 42 lymph nodes were removed (range 11 – 107), and a median of 2 lymph nodes (range 1 – 25) were found positive. 57 (66.3%) patients had a LND < 10% and 29 (33.7%) patients had a LND ≥ 10%. There was no significant association between LND (≥ 10% vs. < 10%) and OS in both univariable (hazard ratio[HR] 1.49, 95% CI 0.72 – 3.07, p = 0.280) and multivariable survival analysis (HR 1.46, 95% CI 0.64 – 3.32, p = 0.372), respectively. However, LND was significantly associated with DFS in univariable analysis (HR 2.11, 95% CI 1.10 – 4.03, p = 0.024) and was found to be an independent predictor for DFS in adjusted multivariable analysis (HR 2.30, 95% CI 1.08 – 4.91, p = 0.031). Conclusions: LND ≥ 10% in patients with lymph node-positive cervical cancer is associated with a worsened DFS compared to patients with a LND < 10%. Thus, LND may be used as an independent prognostic marker and/or for risk stratification in these patients.

Sign in / Sign up

Export Citation Format

Share Document