Lymphadenectomy for patients with cervical cancer: is it of value?

Introduction: Discovery of positive lymph nodes (LNs) in patients with cervix cancer is important prognostically, may direct adjuvant therapy, and may have therapeutic benefit. The purpose of this Surveillance Epidemiology and End Results (SEER) analysis was to assess the value of lymphadenectomy (LND) in patients with cervical cancer.
Methods: The 17-registry SEER database was searched for patients treated for cervical cancer between 1988 and 1998. Observed survival (OS) and expected survival (ES) were reported with a minimum of 5-year follow-up. Chi-square analysis and log-rank test were used to compare OS and ES.
Results: Between 1988 and 1998, 4,059 of 12,882 patients underwent LND for cervical cancer and were registered. By stage, 2,653 of 7,621 stage I, 341 of 2,042 stage II, 814 of 1,986 stage III, 251 of 1,233 stage IV, and 28 of 226 stage IVA patients underwent LND. Of these, 778 stage III and 210 stage IV patients had a +LN. Patients who underwent LND had improved OS (P = 0.001). OS was significantly increased for each stage after LND. OS increased based on number of nodes resected. OS increased up to 15 nodes resected (P = 0.01).
Conclusion: This SEER analysis of 12,882 patients suggests that LND benefited patients with cervical cancer and OS was improved.
((c) 2009 Wiley-Liss, Inc.)