| Summary: | Yoon Hee Lee,1– 3 Gun Oh Chong,1– 3 Su Jeong Kim,1,2 Ja Hyun Hwang,1,2 Jong Mi Kim,1,2 Nora Jee-Young Park,3,4 Dae Gy Hong1,2 1Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; 2Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; 3Clinical Omics Research Center, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; 4Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaCorrespondence: Gun Oh ChongKyungpook National University Chilgok Hospital, 807 Hogukno, Buk-Gu, Daegu, 700-720, Republic of KoreaTel +82-53-200-2684Fax +82-53-200-2028Email gochong@knu.ac.krObjective: This study evaluated the prognostic value of various lymph node (LN) characteristics, including the lymph node ratio (LNR), in patients with cervical cancer treated with radical hysterectomy.Methods: In this retrospective study, 260 patients with cervical cancer who had undergone radical hysterectomy with pelvic or paraaortic lymphadenectomies were included. LN characteristics related to several LN statuses included total LN counts, LN metastasis, total positive LN counts, LNR, and levels of lymphadenectomy. LNR was defined as the number of metastatic LNs divided by the total number of LNs harvested. Univariate and multivariate analyses for disease-free survival (DFS) and overall survival (OS) were performed using the clinicopathological and LN characteristics.Results: Based on receiver-operating characteristics curve analysis, the cut-off value of LNR was 0.0625. Multivariate analysis revealed that high LNR was significantly related to tumor recurrence (hazard ratio [HR], 5.182; 95% confidence interval [CI], 2.424– 11.075; p < 0.0001). After adjusting for clinicopathological factors, LNR was also independent prognostic factor for predicting tumor recurrence (HR, 5.930; 95% CI, 2.114– 16.634; p = 0.0007). However, total retrieved LN counts and level of lymphadenectomy were not associated with survival outcomes.Conclusion: LNR may be a prognostic biomarker for predicting disease recurrence in cervical cancer treated with radical hysterectomy.Keywords: cervical cancer, lymph node ratio, radical hysterectomy, prognosis
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