Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort
Background The impact of examined lymph node (LN) count on survival in cervical cancer remains understudied, with no consensus on the optimal number required.Objectives We aimed to investigate the role of LN count in postoperative pathological evaluation for cervical cancer patients undergoing surge...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2459821 |
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| author | Tao Guo Yuxi Zhao Jia Zeng Jian Li Enyu Tang Lingying Wu |
| author_facet | Tao Guo Yuxi Zhao Jia Zeng Jian Li Enyu Tang Lingying Wu |
| author_sort | Tao Guo |
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| description | Background The impact of examined lymph node (LN) count on survival in cervical cancer remains understudied, with no consensus on the optimal number required.Objectives We aimed to investigate the role of LN count in postoperative pathological evaluation for cervical cancer patients undergoing surgery.Methods Data from the US SEER database and a retrospective Chinese cohort were analyzed. Multivariable logistic and Cox regression models assessed LN positivity detection and overall survival (OS), respectively. Smoothing spline curves and Chow tests identified structural change points in hazard ratios and LN-positive ratios.Results Among 14,133 SEER and 2,811 Chinese cases, higher LN counts correlated with increased detection of positive LNs (OR: 1.040, 95% CI: 1.019–1.062) and improved OS (HR: 0.990, 95% CI: 0.984–0.996). Structural change points occurred at 20 LNs for LN-negative patients and 13 LNs for LN-positive patients (both P < 0.001). An elevated LN-positive ratio (positive/examined LNs) strongly predicted worse OS (HR: 4.208; 95% CI: 1.454–12.181).Conclusions An increased number of examined LNs significantly contributes to the detection of positive LNs and improved patient survival. For patients with claimed LN-negative and LN-positive disease, a minimum examination of 20 and 13 LNs, respectively, is recommended to ensure adequate LN evaluation. The LN positive ratio is a strong prognostic indicator in patients with LN-positive disease. |
| format | Article |
| id | doaj-art-fef2171ff311467f9a0c906c207ed6b7 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-fef2171ff311467f9a0c906c207ed6b72025-02-03T15:47:22ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2459821Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohortTao Guo0Yuxi Zhao1Jia Zeng2Jian Li3Enyu Tang4Lingying Wu5Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaDepartment of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaDepartment of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaDepartment of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaDepartment of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaDepartment of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. ChinaBackground The impact of examined lymph node (LN) count on survival in cervical cancer remains understudied, with no consensus on the optimal number required.Objectives We aimed to investigate the role of LN count in postoperative pathological evaluation for cervical cancer patients undergoing surgery.Methods Data from the US SEER database and a retrospective Chinese cohort were analyzed. Multivariable logistic and Cox regression models assessed LN positivity detection and overall survival (OS), respectively. Smoothing spline curves and Chow tests identified structural change points in hazard ratios and LN-positive ratios.Results Among 14,133 SEER and 2,811 Chinese cases, higher LN counts correlated with increased detection of positive LNs (OR: 1.040, 95% CI: 1.019–1.062) and improved OS (HR: 0.990, 95% CI: 0.984–0.996). Structural change points occurred at 20 LNs for LN-negative patients and 13 LNs for LN-positive patients (both P < 0.001). An elevated LN-positive ratio (positive/examined LNs) strongly predicted worse OS (HR: 4.208; 95% CI: 1.454–12.181).Conclusions An increased number of examined LNs significantly contributes to the detection of positive LNs and improved patient survival. For patients with claimed LN-negative and LN-positive disease, a minimum examination of 20 and 13 LNs, respectively, is recommended to ensure adequate LN evaluation. The LN positive ratio is a strong prognostic indicator in patients with LN-positive disease.https://www.tandfonline.com/doi/10.1080/07853890.2025.2459821Cervical cancerlymphadenectomylymph node countlymph node positive ratio |
| spellingShingle | Tao Guo Yuxi Zhao Jia Zeng Jian Li Enyu Tang Lingying Wu Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort Annals of Medicine Cervical cancer lymphadenectomy lymph node count lymph node positive ratio |
| title | Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort |
| title_full | Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort |
| title_fullStr | Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort |
| title_full_unstemmed | Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort |
| title_short | Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort |
| title_sort | examined lymph node counts affected the staging and survival in cervical cancer a retrospective study using the seer and chinese cohort |
| topic | Cervical cancer lymphadenectomy lymph node count lymph node positive ratio |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2459821 |
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