A survey of lymph node involvement under preoperative medical imaging in cervical cancer patients

Objective: To investigate the characteristics and distribution patterns of clinically metastatic nodes assessed by Computed Tomography (CT) in preoperative cervical cancer patients; to address the importance of obturator and/or inguinal lymph nodes as sentinel lymph nodes. Methods: A total of 217 patients with cervical carcinoma treated by lymph node dissection (LND) between 2009 and 2014 were included. All preoperative CT/MRI (Magnetic Resonance Imaging) imaging data of these patients were reviewed. The relationship of patient characteristics age, tumor stages, and corresponding lymph node metastasis status were analyzed. We put emphasis on the distribution pattern of positive lymph nodes from pre-operative imaging and compared the different frequencies of each regional and non-regional lymph node group respectively. The data of the 5-year survival rate from follow-up was taken into consideration too. SPSS 24.0 (IBM Corp., Chicago, IL, USA) was used for statistical analysis. Results: The overall lymph node metastasis (LNM) rate was 92.6% in 217 cases. When regional nodes were involved, obturator groups were concerned in 154 (76.6%). The inguinal group was involved in 146 (72.6%) in the area of non-regional lymph node. The 5-year survival rates of return visits were 92.6% and 82.1% in stage IB and IIA, respectively. Age distribution was not associated with the International Federation of Gynecology and Obstetrics (FIGO) stage as well as the incidence and patterns of nodal metastasis. Conclusions: obturator and inguinal groups play a decisive role in the metastases process of cervical cancer, and can be regarded as a candidate for sentinel lymph nodes.