Background: The differences in lymph node metastasis (LNM) between patients with early-stage squamous cell carcinoma (SCC) and adenocarcinoma (ADC) cervical cancer remained to be clarified. Objectives: To compare the differences of LNM between early-stage SCC and ADC cervical cancer patients receiving radical surgery and adjuvant radiotherapy. Designs: A retrospective large cohort study. Methods: The pelvic LNM rate was estimated and compared. Univariate and multivariate logistic regression analyses were applied to identify the risk factors for pelvic LNM. The cumulative survival rates were estimated and compared with Kaplan–Meier methods and log-rank test, respectively. The propensity score matching (PSM) was utilized for adjustment of baseline characteristics. Results: A total of 577 cervical cancer patients were included in the analysis. Pelvic LNM could be observed in 22.7% (51/225) of ADC and 25.9% (91/352) of SCC patients ( p = 0.39). Lympho-vascular space involvement (LVSI) was the only risk factor for pelvic LNM in SCC patients while LVSI and parametrial involvement (PI) were risk factors for ADC patients. No significant survival differences were observed between SCC patients with LNM and those without (All p > 0.05). However, ADC patients without pelvic LNM appeared superior to those with LNM in 5-year overall survival whether before (70.7% vs 91.9%; p < 0.001) or after (78.7% vs 92.4%; p = 0.024) PSM. Moreover, consolidate chemotherapy after radiation improved the 5-year disease-free survival (DFS) for SCC patients with pelvic LNM (74.9% vs 96.8%; p = 0.019) while not for ADC patients (68.9% vs 64.1%; p = 0.8). Conclusion: No significant difference in pelvic LNM rate was observed between ADC and SCC patients. The presence of LNM seemed to further impair the oncological outcomes for ADC while not for SCC patients. Consolidate chemotherapy appeared to improve the DFS for SCC while not for ADC patients.
Miao et al. (Sun,) studied this question.
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