Outcome of cervical cancer patients with single-node compared with no nodal involvement treated with radical hysterectomy and pelvic lymphadenectomy

Abstract Objective To evaluate disease-free survival (DFS) after radical hysterectomy and pelvic lymphadenectomy (RHPL) among early-stage cervical cancer patients with single-node involvement versus patients with no nodal involvement. Methods A retrospective review was conducted of the medical records of 843 patients undergoing RHPL at Chiang Mai University Hospital, Thailand, between January 1, 2002, and December 31, 2008. Neoadjuvant chemotherapy was administered when the operative schedule was more than 1 month after diagnosis and adjuvant chemoradiation was administered to high-risk patients. Five subgroups were defined on the basis of pelvic node involvement: group A (0 nodes; n = 706), group B (1 node; n = 65), group C (2 nodes; n = 38), group D (3 nodes; n = 13), and group E (≥ 4 nodes; n = 21). Results The 5-year DFS was comparable for groups A and B (94.3% versus 92.1%; P = 0.454). In groups C, D, and E, the 5-year DFS was 85.9%, 75.0%, and 61.8%, respectively. The survival outcomes for groups A and B were significantly different from those of the other 3 groups ( P < 0.001). Conclusion Cervical cancer patients with single-node involvement had comparable survival outcomes to those without nodal metastases; however, patients with multiple node involvement had reduced DFS.