The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival

Objective: The prognostic impact of surgical paraaortic staging remains unclear in patients with locally advanced cervical cancer (LACC). The objective of our study was to evaluate the results of the surgical technique of preoperative aortic lymphadenectomy in LACC related to tumor burden and diseas...

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Autores: Llueca, Antoni, Escrig, Javier, Gil Moreno, Antonio, Benito, Virginia, Hernández, Alicia, Díaz Feijoo, Berta, Spain-Gynecologic Oncology Group (GOG) Working Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/221709
Acceso en línea:https://hdl.handle.net/2445/221709
Access Level:acceso abierto
Palabra clave:Nodes limfàtics
Supervivència
Cirurgia
Metàstasi
Càncer de coll uterí
Lymph nodes
Survival
Surgery
Metastasis
Cervix cancer
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spelling The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survivalLlueca, AntoniEscrig, JavierGil Moreno, AntonioBenito, VirginiaHernández, AliciaDíaz Feijoo, BertaSpain-Gynecologic Oncology Group (GOG) Working GroupNodes limfàticsSupervivènciaCirurgiaMetàstasiCàncer de coll uteríLymph nodesSurvivalSurgeryMetastasisCervix cancerObjective: The prognostic impact of surgical paraaortic staging remains unclear in patients with locally advanced cervical cancer (LACC). The objective of our study was to evaluate the results of the surgical technique of preoperative aortic lymphadenectomy in LACC related to tumor burden and disease spread to assess its influence on survival. Methods: Data of 1,072 patients with cervical cancer were taken from 11 Spanish hospitals (Spain-Gynecologic Oncology Group [GOG] working group). Complete aortic lymphadenectomy surgery (CALS) was considered when the lymph nodes (LNs) were excised up to the left renal vein. The extent of the disease was performed evaluating the LNs by calculating the geometric means and quantifying the log odds between positive LNs and negative LNs. The Kaplan-Meier method was used to estimate the survival distribution. A Cox proportional hazards model was used to account for the influence of multiple variables. Results: A total of 394 patients were included. Pathological analysis revealed positive aortic LNs in 119 patients (30%). LODDS cut-off value of -2 was established as a prognostic indicator. CALS and LODDS <-2 were associated with better disease free survival and overall survival than suboptimal aortic lymphadenectomy surgery and LODDS ≥-2. In a multivariate model analysis, CALS is revealed as an independent prognostic factor in LACC. Conclusion: When performing preoperative surgical staging in LACC, it is not advisable to take simple samples from the regional nodes. Radical dissection of the aortic and pelvic regions offers a more reliable staging of the LNs and has a favorable influence on survival.Korean Society of Gynecologic Oncology2025202520212025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion12 p.application/pdfhttps://hdl.handle.net/2445/221709Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3802/jgo.2021.32.e4Journal of Gynecologic Oncology, 2021, vol. 32, num.1https://doi.org/10.3802/jgo.2021.32.e4cc-by-nc (c) Korean Society of Gynecologic Oncology, 2021http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2217092026-05-29T05:05:01Z
dc.title.none.fl_str_mv The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
title The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
spellingShingle The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
Llueca, Antoni
Nodes limfàtics
Supervivència
Cirurgia
Metàstasi
Càncer de coll uterí
Lymph nodes
Survival
Surgery
Metastasis
Cervix cancer
title_short The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
title_full The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
title_fullStr The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
title_full_unstemmed The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
title_sort The extent of aortic lymphadenectomy in locally advanced cervical cancer impacts on survival
dc.creator.none.fl_str_mv Llueca, Antoni
Escrig, Javier
Gil Moreno, Antonio
Benito, Virginia
Hernández, Alicia
Díaz Feijoo, Berta
Spain-Gynecologic Oncology Group (GOG) Working Group
author Llueca, Antoni
author_facet Llueca, Antoni
Escrig, Javier
Gil Moreno, Antonio
Benito, Virginia
Hernández, Alicia
Díaz Feijoo, Berta
Spain-Gynecologic Oncology Group (GOG) Working Group
author_role author
author2 Escrig, Javier
Gil Moreno, Antonio
Benito, Virginia
Hernández, Alicia
Díaz Feijoo, Berta
Spain-Gynecologic Oncology Group (GOG) Working Group
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Nodes limfàtics
Supervivència
Cirurgia
Metàstasi
Càncer de coll uterí
Lymph nodes
Survival
Surgery
Metastasis
Cervix cancer
topic Nodes limfàtics
Supervivència
Cirurgia
Metàstasi
Càncer de coll uterí
Lymph nodes
Survival
Surgery
Metastasis
Cervix cancer
description Objective: The prognostic impact of surgical paraaortic staging remains unclear in patients with locally advanced cervical cancer (LACC). The objective of our study was to evaluate the results of the surgical technique of preoperative aortic lymphadenectomy in LACC related to tumor burden and disease spread to assess its influence on survival. Methods: Data of 1,072 patients with cervical cancer were taken from 11 Spanish hospitals (Spain-Gynecologic Oncology Group [GOG] working group). Complete aortic lymphadenectomy surgery (CALS) was considered when the lymph nodes (LNs) were excised up to the left renal vein. The extent of the disease was performed evaluating the LNs by calculating the geometric means and quantifying the log odds between positive LNs and negative LNs. The Kaplan-Meier method was used to estimate the survival distribution. A Cox proportional hazards model was used to account for the influence of multiple variables. Results: A total of 394 patients were included. Pathological analysis revealed positive aortic LNs in 119 patients (30%). LODDS cut-off value of -2 was established as a prognostic indicator. CALS and LODDS <-2 were associated with better disease free survival and overall survival than suboptimal aortic lymphadenectomy surgery and LODDS ≥-2. In a multivariate model analysis, CALS is revealed as an independent prognostic factor in LACC. Conclusion: When performing preoperative surgical staging in LACC, it is not advisable to take simple samples from the regional nodes. Radical dissection of the aortic and pelvic regions offers a more reliable staging of the LNs and has a favorable influence on survival.
publishDate 2021
dc.date.none.fl_str_mv 2021
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/221709
url https://hdl.handle.net/2445/221709
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3802/jgo.2021.32.e4
Journal of Gynecologic Oncology, 2021, vol. 32, num.1
https://doi.org/10.3802/jgo.2021.32.e4
dc.rights.none.fl_str_mv cc-by-nc (c) Korean Society of Gynecologic Oncology, 2021
http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc (c) Korean Society of Gynecologic Oncology, 2021
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 12 p.
application/pdf
dc.publisher.none.fl_str_mv Korean Society of Gynecologic Oncology
publisher.none.fl_str_mv Korean Society of Gynecologic Oncology
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429