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Publications

Journal Article Multicenter Study Comparative Study Ppublish

PubMed: 41326214 DOI: 10.1016/j.ejso.2025.110490

Locally advanced cervical cancer and para-aortic lymphadenectomy: impact of the number of removed lymph nodes, a FRANCOGYN group study.

Eur J Surg Oncol 51(12):110490

Authors: E Lugan, A Lacorre, F Margueritte, L Ouldamer, Y Kerbage, X Carcopino, P A Bolze, C Akladios, E Raimond, V Lavoue, C Touboul, G Canlorbe, A Bricou, Y Dabi, J Uzan, C Huchon, T Gauthier

Affiliations

  • Departement of Obstetrics and Gynaecology, HFME, Limoges University Hospital, Limoges, France.
  • Department of Gynaecology, CHRU de Tours, Hôpital Bretonneau, INSERM Unit, 1069, 2 boulevard Tonnellé, 37044, Tours, France.
  • Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France.
  • Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE, UMR 7263, 13397, Marseille, France.
  • Department of Gynaecologic and Oncologic Surgery and Obstetrics, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Université Lyon 1, France.
  • Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Department of Obstetrics and Gynaecology, Alix de Champagne Institute, Centre Hospitalier Universitaire, 45 rue Cognacq-Jay, 51092, Reims, France.
  • Department of Gynaecology, CHU de Rennes, France; INSERM, 1242, COSS, Rennes, Université de Rennes 1, France.
  • Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.
  • Department of Gynecologic and Breast Surgery and Oncology, Hôpital la Pitié Salpétrière, University Institute of Cancer (IUC), AP-HP, Sorbonne University, Paris, France; Saint-Antoine Research Center (CRSA), INSERM UMR_S_938, Biology and Therapeutics of Cancer, Sorbonne University, Paris, France.
  • Department of Gynecology, Bobigny University, AP-HP, Jean-Verdier Hospital, Bondy, 93140, France.
  • Department of Obstetrics Gynecology and Reproductive Medicine, University Paris Est Créteil, Centre Hospitalier Inter-Communal de Créteil, Creteil, 94000, France.
  • APHP, Service de gynécologie & obstétrique, GH Saint-Louis Lariboisière-Fernand Widal, Hôpital Lariboisière, Université de Paris, 2, rue Ambroise Paré, 75010, Paris, France.
  • Departement of Obstetrics and Gynaecology, HFME, Limoges University Hospital, Limoges, France; Pharmacology and Transplantation, INSERM U1248, Université de Limoges, 2 Rue du Pr Descottes, 87000, Limoges, France.

Abstract

INTRODUCTION

Cervical cancer is the fourth most common cancer worldwide among women. Surgical staging by para-aortic lymph node dissection (PALND) is performed when the cancer is locally advanced (LACC). There are no recommendations concerning the number of lymph node that must be removed during this surgery which hasn't prove is effectiveness concerning survival.

PATIENTS AND METHODS

We conducted a retrospective multicenter descriptive and comparative study with data from FRANCOGYN group. We included 578 patients with LACC (IB3-IVA FIGO 2028) who underwent a PALND, 190 with <10 nodes and 388 with at least 10 nodes. The primary outcome was to evaluate the impact of the number of lymph nodes removed on the positivity of the staging. The secondary outcomes were to evaluate the impact of the number of lymph nodes removed on the treatment, the morbidity and the survival of the patients.

RESULTS

There was no significant difference concerning the positivity of the staging between the two groups with 17,4 % and 16,2 % of positive staging (p = 0,8). There were no significant differences concerning the peri and post operative complications, the modification of the stage and treatment or the OS and DFS.

CONCLUSION

It would appear that para-aortic staging with at least 10 or more nodes does not confer any advantage in terms of positivity and survival over staging with fewer than 10 nodes.

MeSH

Lymph Nodes, Lymph Node Excision, Uterine Cervical Neoplasms, Neoplasms, Lymph, Therapeutics, Medical Oncology