METHODS: Patients with CC who underwent radical hysterectomy with pelvic lymphadenectomy were identified for a propensity score-matched (PSM) cohort study. A receiver operating characteristic (ROC) curve analysis was performed to determine the critical nMLN and LNR values. Five-year overall survival (OS) and disease-free survival (DFS) rates were compared using Kaplan-Meier and Cox proportional hazard regression analyses.
RESULTS: This study included 3,135 CC patients with stage FIGO 2018 IIICp from 47 Chinese hospitals between 2004 and 2018. Based on ROC curve analysis, the cut-off values for nMLN and LNR were 3.5 and 0.11, respectively. The final cohort consisted of nMLN ≤ 3 (n = 2,378) and nMLN > 3 (n = 757) groups and LNR ≤ 0.11 (n = 1,748) and LNR > 0.11 (n = 1,387) groups. Significant differences were found in survival between the nMLN ≤ 3 vs the nMLN > 3 (post-PSM, OS: 76.8% vs 67.9%, P = 0.003; hazard ratio [HR]: 1.411, 95% confidence interval [CI]: 1.108-1.798, P = 0.005; DFS: 65.5% vs 55.3%, P < 0.001; HR: 1.428, 95% CI: 1.175-1.735, P < 0.001), and the LNR ≤ 0.11 and LNR > 0.11 (post-PSM, OS: 82.5% vs 76.9%, P = 0.010; HR: 1.407, 95% CI: 1.103-1.794, P = 0.006; DFS: 72.8% vs 65.1%, P = 0.002; HR: 1.347, 95% CI: 1.110-1.633, P = 0.002) groups.
CONCLUSIONS: This study found that nMLN > 3 and LNR > 0.11 were associated with poor prognosis in CC patients.
方法:接受根治性子宫切除术伴盆腔淋巴结清扫术的CC患者被确定为倾向评分匹配(PSM)队列研究。进行受试者工作特征(ROC)曲线分析以确定临界nMLN和LNR值。使用Kaplan-Meier和Cox比例风险回归分析比较了5年总生存率(OS)和无病生存率(DFS)。
结果:本研究包括2004年至2018年间来自47家中国医院的3,135名FIGO2018IIICp期CC患者。基于ROC曲线分析,nMLN和LNR的截止值分别为3.5和0.11。最终队列包括nMLN≤3(n=2,378)和nMLN>3(n=757)组和LNR≤0.11(n=1,748)和LNR>0.11(n=1,387)组。nMLN≤3与nMLN>3之间的生存率存在显着差异(PSM后,操作系统:76.8%vs67.9%,P=0.003;风险比[HR]:1.411,95%置信区间[CI]:1.108-1.798,P=0.005;DFS:65.5%vs55.3%,P<0.001;HR:1.428,95%CI:1.175-1.735,P<0.001),LNR≤0.11且LNR>0.11(PSM后,操作系统:82.5%vs76.9%,P=0.010;HR:1.407,95%CI:1.103-1.794,P=0.006;DFS:72.8%vs65.1%,P=0.002;HR:1.347,95%CI:1.110-1.633,P=0.002)组。
结论:本研究发现nMLN>3和LNR>0.11与CC患者的不良预后相关。