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...
| Autores: | , , , , , , |
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| 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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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 |
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Recercat. Dipósit de la Recerca de Catalunya |
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15.812429 |