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Prognostic value of lymph node ratio in patients with small-cell carcinoma of the cervix based on data from a large national registry

Authors Zhou J, Sun J, Chen S, Li F, Lin H, Wu S, He Z

Received 11 September 2015

Accepted for publication 16 November 2015

Published 23 December 2015 Volume 2016:9 Pages 67—73

DOI https://doi.org/10.2147/OTT.S96206

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Professor Daniele Santini


Juan Zhou,1,* Jia-Yuan Sun,2,* Shan-Yu Chen,3 Feng-Yan Li,2 Huan-Xin Lin,2 San-Gang Wu,3 Zhen-Yu He2

1Department of Obstetrics and Gynecology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, 2Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 3Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China

*These authors contributed equally to this work


Objective: To investigate the prognostic value of the lymph node ratio (LNR) in patients with small-cell carcinoma of the cervix (SCCC) after cancer-directed surgery using a population-based national registry (Surveillance Epidemiology and End Results [SEER]).
Methods: We retrospectively reviewed the data of SCCC patients in the SEER database from 1980 to 2012. The prognostic impact of LNR with respect to cause-specific survival (CSS) and overall survival (OS) was analyzed.
Results: A total of 118 patients with SCCC were identified. The median follow-up was 30.5 months. All these patients were treated with cancer-directed surgery and lymphadenectomy. Sixty (50.8%) patients had nodal metastases. The median LNR was 0.16 in patients with positive lymph nodes. Univariate analysis showed that prognostic factors such as International Federation of Gynecology and Obstetrics (FIGO) stage, nodal status, LNR, and local treatment modalities affected CSS and OS (P<0.05). Multivariate analysis showed that LNR was an independent prognostic factor for CSS and OS. Patients with a higher LNR had worse CSS (hazard ratio [HR]: 8.832; 95% confidence interval [CI]: 3.762–20.738; P<0.001) and OS (HR: 8.462; 95% CI: 3.613–19.821; P<0.001). LNR was associated with CSS and OS by stage, especially in FIGO stage I–II patients.
Conclusion: LNR is an independent prognostic factor in SCCC patients and it may help to individualize adjuvant therapy.

Keywords: small-cell carcinoma of the cervix, SEER, lymph node ratio, lymph node, prognostic factors

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