| Objective:To investigate the characteristics of lymphatic metastasis of locally advanced cervical cancer(LACC)and the prognostic of patients with LACC(FIGO ⅠB2/ⅡA2).Methods:1.We reviewed clinical records and follow-up information of patients with cervical cancer(FIGO ⅠA2-ⅡA2)after radical hysterectomy in Department of Gynecology,Jiangsu Provincial People’s Hospital From January 2008 to December 2016.2.A total of 424 patients who satisfied the criteria were followed by telephone or short messages.3.We did a statistical analysis by SPSS 18.0.Constituent ratio was compared with chi-square test,and operated univariate analysis with COX,multi-factor analysis with Logistic regression analysis and survival rate with Kaplan Meier method,inspection standard for α=0.05.Results:1.A total of 51 cases of patients with ⅠA2-ⅡA2 stage cervical cancer confirmed by pathology of Lymph node metastasis.Univariate analysis showed that the incidence of lymphatic metastasis in patients with ⅠA2-ⅡA2 stage was correlated with locally advanced stage,differentiation degree,deep muscular layer invasion,lymph vascular space invasion(LVSI)and parametrium involved(P<0.05).2.And multivariate analysis showed that deep muscular layer invasion and LVSI were identified as independent risk factor(P<0.05)in patients with IA2-IIA2 stage cerical cancer.3.Lymph node metastases were confirmed by pathological diagnosis in 20 locally advanced stage(ⅠB2/ⅡA2 stage)cervical cancer cases.Univariate analysis showed that the incidence of lymphatic metastasis in patients with ⅠB2/ⅡA2 stage was correlated with deep muscular layer invasion and LVSI(P<0.05).4.And multivariate analysis showed that LVSI was identified as an independent risk factor(P<0.05)in patients with locally advanced stage(ⅠB2/ⅡA2 stage)cervical cancer.5.Kaplan-meier survival analysis indicated that the overall survival period of cervical cancer in patients with ⅠA2-ⅡA2 stage cerical cancer was 104.8 months(102.0 months to 107.6 months),and the disease-free survival was about 101.9 months(98.8 months to 105.0 months).6.Kaplan-meier survival analysis indicated that the overall survival period and disease-free survival period of locally advanced(ⅠB2/ⅡA2)cervical cancer were significantly shorter than that of ⅠA2/ⅠB1/ⅡA2 stages(106.679 months vs.98.876 months,P=0.009).102.975 months vs.97.800 months,P=0.120),and the difference in total survival period was statistically significant.7.For patients with locally advanced(ⅠB2/ⅡA2 stage)cervical cancer,the lymph node metastasis rate of neoadjuvant chemotherapy group was lower than that of the radical surgery without NACT group,but the difference was not statistically significant(P<0.05).8.For patients with locally advanced(ⅠB2/ⅡA2 stage)cervical cancer,there was no significant difference between the neoadjuvant chemotherapy group and the neoadjuvant chemotherapy group on account of the surgical complications(P>0.05)..Conclusion:1.Locally advanced cervical cancer has higher lymphatic metastasis rate than stage ⅠA2/ⅠB1/ⅡA1 cervical cancer.2.Lymph nodes metastasis rate was correlated with deep muscular layer invasion and LVSI and LVSI is independent risk factor in patients with cervical cancer(FIGO ⅠB2/ⅡA2).3.Patients with cervical cancer(FIGO ⅠB2/ⅡA2)have poor prognosis than those with cervical cancer(FIGO ⅠA2/ⅠB1/ⅡA1).But what impacts the overall survival and disease-free survival is not confirmed.4.In patients with locally advanced cervical cancer(ⅠB2/ⅡA2 period),lymph node metastasis rate of neoadjuvant chemotherapy group is lower than that of the radical surgery without NACT group,but not statistical significant.On account of complications related to the operation,there is no obvious difference between the two groups. |
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