Predictive factors of lymph node metastasis in patients with 2014 figo stage Ib1-IIa2 cervical squamous cell cancer: A multicentric study

Aim: The objective of this study is to identify the risk variables associated with lymph node metastasis (LNM) in individuals diagnosed with cervical squamous cell carcinoma (SCC). Material and Methods: Cervical cancer patients who underwent type II/III radical hysterectomy and pelvic lymphadenectomy +/- para-aortic lymphadenectomy were analyzed. Results: In total, 422 SCC patients were included in the cohort. Three hundred-twenty-three (76.5%) patients were stage IB1, 59 (14%) were stage IB2, 33 (7.8%) were stage IIA1, and 7 (1.7%) were stage IIA2. Eighty-seven (20.6%) patients had LNM only in the pelvic region, 2 (0.5%) patients in the paraaortic region, and 8 (1.9%) patients in both regions. In the multivariate logistic analysis, parametrial invasion (hazard ratio [HR]: 2.182, 95% confidence interval [CI]: 1.090-4.366, p=0.027), lymphovascular space invasion (LVSI) (HR: 6.300, 95% CI: 2.968-13.370, p<0.001) and deep stromal invasion (HR: 2.122, 95% CI: 1.088-4.139, p=0.027) were identified as significant risk factors for LNM. Discussion: In summary, age, FIGO stage, tumor size, vaginal invasion, surgical border involvement, and uterine involvement were not identified as independent risk factors for LNM. However, parametrial invasion, LVSI, and deep stromal invasion are independent risk factors for LNM in stage IB1-IIA2 cervical SCC patients.