Evaluation of the Risk Factors for Pelvic Lymph Node Metastasis in Early Stage Cervical Cancer

摘要

Objective : This study evaluated the risk factors for pelvic lymph node metastasis in patients with early stage cervical cancer. Material and Methods: A cross sectional study was carried out in the Division of Gynaecologic Oncology at Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2014 and July 2015 to evaluate demographic factors and histopathological findings of women with cervical cancer stage IB-IIA who underwent primary radical hysterectomy and bilateral pelvic lymph node dissection. Results: Fifty women aged 30 years or above were included in the study. Lymph node metastases were identified in 20% of patients. By univariate analysis, preoperative anemia, a history of smoking, tumor size greater than 4 cm and lack of cervical inflammatory reaction by histopathology were significant variables associated with lymph node metastasis. Multivariate analysis showed that the lack of inflammatory reaction in the uterine cervix was the most important predictor for pelvic lymph node metastasis when adjusting for other variables. Moderate to severe inflammatory reaction in the uterine cervix was 18 times less likely to have pelvic lymph node metastasis than those who had mild inflammation. Conclusion: An association was found between the presence of pelvic lymph node metastasis in cervical cancer and certain variables: the lack of contraceptive use, smoking, preoperative anemia, bulky tumors, invasion of deep two-third of the uterine cervix, mild inflammatory reaction in the cervix, and keratinizing carcinoma. After adjusting for other factors, presence or absence of inflammatory reaction in the cervix was found to be the most important predictor for pelvic lymph node metastasis.