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