Clinical Research Papers:

The prognostic value of negative lymph node count for patients with cervical cancer after radical surgery

Hao Lu, Rong Guo, Haotian Yang, Haolu Wang, Xiaowen Liang, Zhiqian Hu and Xinxing Li _

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Oncotarget. 2018; 9:2810-2818. https://doi.org/10.18632/oncotarget.23596

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Hao Lu1,*, Rong Guo2,*, Haotian Yang3,4,*, Haolu Wang3, Xiaowen Liang3, Zhiqian Hu1 and Xinxing Li1

1Department of General Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, China

2The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China

3Therapeutics Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Woolloongabba, QLD, Australia

4School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia

*These authors contributed equally to this work

Correspondence to:

Xinxing Li, email: [email protected]

Zhiqian Hu, email: [email protected]

Keywords: negative lymph node; cervical cancer; radical surgery; SEER

Received: July 18, 2017     Accepted: December 15, 2017     Published: December 21, 2017


Negative lymph node (NLN) count has been recognized as a prognostic indicator in various cancers. However, the relationship between NLN count and the prognosis of cervical cancer is still unknown. In this study, 10, 500 cervical cancer patients after radical surgery were selected from Epidemiology and End Results Program (SEER) data. Clinicopathological characteristics were collected for analysis, including year of diagnosis, age, race, grade, primary site, FIGO stage and cause specific survival (CSS). Univariate and multivariate Cox proportional hazards model was used to assess risk factors for survival of patients. X-tile plots identified 6 as the optimal cutoff value of NLN count to divide patients into high and low risk subsets in terms of CSS (χ2 = 183.95, P < 0.001). The rate of 5-year CCS of cervical cancer patients was improved with an increase in NLN count from 0 to 23 (all P < 0.001). NLN count was validated as an independently prognostic factor by the multivariate Cox analysis (HR: 1.571, 95% CI: 1.370~1.801, P < 0.001). Subgroup analysis showed that NLN count was a prognosis factor in FIGO stage I (χ2=35.023, P < 0.001), stage II (χ2 = 12.910, P < 0.001), stage III + IV (χ2 = 9.732, P = 0.002) and unknown stage (χ2 = 16.654, P < 0.001). Conclusively, this study demonstrated the NLN count was an independent prognostic factor for cervical cancer patients.

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