Retrospective cohort study demonstrates post-chemoradiotherapy lymph node size predicts residual nodal metastasis in cervical cancer, indicating its diagnostic value for monitoring.
Key Points
To evaluate the diagnostic accuracy of post-concurrent chemoradiotherapy (CCRT) pelvic lymph node size for predicting residual pathological nodal involvement in cervical cancer.
Retrospective cohort study of 57 patients with cervical cancer treated with CCRT followed by planned surgery with pelvic lymphadenectomy.
Computed tomography scans before and after CCRT were used to measure the short- and long-axis diameters of the largest pelvic lymph node, validated against histopathological findings using ROC analysis.
Pathological nodal metastasis was confirmed in 17 of 57 patients (29.8%), with post-CCRT lymph node diameters significantly larger in the ypN1 group than in the ypN0 group.
Short-axis diameter showed greater diagnostic performance than long-axis diameter, with an area under the curve of 0.859 (95% CI, 0.752–0.966) versus 0.802 (95% CI, 0.676–0.927).
At a 7-mm short-axis cutoff, sensitivity was 58.8%, specificity was 90.0%, positive predictive value was 71.4%, negative predictive value was 83.7%, and overall diagnostic accuracy was 80.7%.