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Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer

PURPOSE: The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment. MATERIALS AND METHODS: Fifty high-r...

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Autores principales: Kwon, Jeanny, Eom, Keun-Yong, Kim, In Ah, Kim, Jae-Sung, Kim, Young-Beom, No, Jae Hong, Kim, Kidong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843724/
https://www.ncbi.nlm.nih.gov/pubmed/26194370
http://dx.doi.org/10.4143/crt.2015.085
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author Kwon, Jeanny
Eom, Keun-Yong
Kim, In Ah
Kim, Jae-Sung
Kim, Young-Beom
No, Jae Hong
Kim, Kidong
author_facet Kwon, Jeanny
Eom, Keun-Yong
Kim, In Ah
Kim, Jae-Sung
Kim, Young-Beom
No, Jae Hong
Kim, Kidong
author_sort Kwon, Jeanny
collection PubMed
description PURPOSE: The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment. MATERIALS AND METHODS: Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. RESULTS: The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). CONCLUSION: LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF.
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spelling pubmed-48437242016-05-06 Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer Kwon, Jeanny Eom, Keun-Yong Kim, In Ah Kim, Jae-Sung Kim, Young-Beom No, Jae Hong Kim, Kidong Cancer Res Treat Original Article PURPOSE: The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment. MATERIALS AND METHODS: Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. RESULTS: The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). CONCLUSION: LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF. Korean Cancer Association 2016-04 2015-07-14 /pmc/articles/PMC4843724/ /pubmed/26194370 http://dx.doi.org/10.4143/crt.2015.085 Text en Copyright © 2016 by the Korean Cancer Association This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-CommercialLicense (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original workis properlycited.
spellingShingle Original Article
Kwon, Jeanny
Eom, Keun-Yong
Kim, In Ah
Kim, Jae-Sung
Kim, Young-Beom
No, Jae Hong
Kim, Kidong
Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title_full Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title_fullStr Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title_full_unstemmed Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title_short Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
title_sort prognostic value of log odds of positive lymph nodes after radical surgery followed by adjuvant treatment in high-risk cervical cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843724/
https://www.ncbi.nlm.nih.gov/pubmed/26194370
http://dx.doi.org/10.4143/crt.2015.085
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