Predictive value of number of metastatic lymph nodes and lymph node ratio for prognosis of patients with FIGO 2018 stage IIICp cervical cancer: a multi-center retrospective study.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
13 Aug 2024
Historique:
received: 30 08 2023
accepted: 08 08 2024
medline: 14 8 2024
pubmed: 14 8 2024
entrez: 13 8 2024
Statut: epublish

Résumé

To identify the cut-off values for the number of metastatic lymph nodes (nMLN) and lymph node ratio (LNR) that can predict outcomes in patients with FIGO 2018 IIICp cervical cancer (CC). 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. 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. This study found that nMLN > 3 and LNR > 0.11 were associated with poor prognosis in CC patients.

Sections du résumé

BACKGROUND BACKGROUND
To identify the cut-off values for the number of metastatic lymph nodes (nMLN) and lymph node ratio (LNR) that can predict outcomes in patients with FIGO 2018 IIICp cervical cancer (CC).
METHODS 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 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 CONCLUSIONS
This study found that nMLN > 3 and LNR > 0.11 were associated with poor prognosis in CC patients.

Identifiants

pubmed: 39138415
doi: 10.1186/s12885-024-12784-8
pii: 10.1186/s12885-024-12784-8
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1005

Informations de copyright

© 2024. The Author(s).

Références

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660 .
doi: 10.3322/caac.21660 pubmed: 33538338
Miyahara S, Tsuji K, Shimada M, Shibuya Y, Shigeta S, Nagai T, et al. The impact of histological subtype on survival outcome of patients with stage IIB-IVA cervical cancer who received definitive radiotherapy. Tohoku J Exp Med. 2021;55(4):303–13. https://doi.org/10.1620/tjem.255.303 .
doi: 10.1620/tjem.255.303
Chen W, Xiu S, Xie X, Guo H, Xu Y, Bai P, et al. Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer. Radiat Oncol. 2022;17(1):6. https://doi.org/10.1186/s13014-021-01978-0 . Published 2022 Jan 10.
doi: 10.1186/s13014-021-01978-0 pubmed: 35012582 pmcid: 8751300
Qin F, Pang H, Yu T, Luo Y, Dong Y. Treatment strategies and prognostic factors of 2018 FIGO stage IIIC cervical cancer: a review. Technol Cancer Res Treat. 2022;21: 15330338221086403. https://doi.org/10.1177/15330338221086403 .
doi: 10.1177/15330338221086403 pubmed: 35341413 pmcid: 8966198
Brodeur MN, Dejean R, Beauchemin MC, Samouëlian V, Cormier B, Bacha OM, et al. Oncologic outcomes in the era of modern radiation therapy using FIGO 2018 staging system for cervical cancer. Gynecol Oncol. 2021;162(2):277–83. https://doi.org/10.1016/j.ygyno.2021.05.023 .
doi: 10.1016/j.ygyno.2021.05.023 pubmed: 34059350
Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri: 2021 update. Int J Gynaecol Obstet. 2021;155 Suppl 1(Suppl 1):28–44. https://doi.org/10.1002/ijgo.13865 .
doi: 10.1002/ijgo.13865 pubmed: 34669203
Kwon J, Eom KY, Kim YS, Park W, Chun M, Lee J, et al. The prognostic impact of the number of metastatic lymph nodes and a new prognostic scoring system for recurrence in early-stage cervical cancer with high risk factors: a multicenter cohort study (KROG 15–04). Cancer Res Treat. 2018;50(3):964–74. https://doi.org/10.4143/crt.2017.346 .
doi: 10.4143/crt.2017.346 pubmed: 29081219
Lee YJ, Kim DY, Lee SW, Park JY, Suh DS, Kim JH, et al. A postoperative scoring system for distant recurrence in node-positive cervical cancer patients after radical hysterectomy and pelvic lymph node dissection with para-aortic lymph node sampling or dissection. Gynecol Oncol. 2017;144(3):536–40. https://doi.org/10.1016/j.ygyno.2017.01.001 .
doi: 10.1016/j.ygyno.2017.01.001 pubmed: 28108027
Yan DD, Tang Q, Tu YQ, Chen JH, Lv XJ. A comprehensive analysis of the factors of positive pelvic lymph nodes on survival of cervical cancer patients with 2018 FIGO stage IIIC1p. Cancer Mana Res. 2019;11:4223–30. https://doi.org/10.2147/CMAR.S204154 .
doi: 10.2147/CMAR.S204154
Pedone AL, Carbone V, Gallotta V, Fanfani F, Cosentino F, Turco LC, et al. Should the number of metastatic pelvic lymph nodes be integrated into the 2018 figo staging classification of early stage cervical cancer? Cancers. 2020;12(6): 1552. https://doi.org/10.3390/cancers12061552 .
doi: 10.3390/cancers12061552
Guo Q, Zhu J, Wu Y, Wen H, Xia L, Ju X, et al. Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients. Ann Transl Med. 2020;8(7):485. https://doi.org/10.21037/atm.2020.03.27 .
doi: 10.21037/atm.2020.03.27 pubmed: 32395529 pmcid: 7210123
Inoue T, Morita K. The prognostic significance of number of positive nodes in cervical carcinoma stages IB, IIA, and IIB. Cancer. 1990;65(9):1923–7. https://doi.org/10.1002/1097-0142(19900501)65:9%3c1923::aid-cncr2820650909%3e3.0.co;2-m .
doi: 10.1002/1097-0142(19900501)65:9<1923::aid-cncr2820650909>3.0.co;2-m pubmed: 2372764
Sakuragi N, Satoh C, Takeda N, Hareyama H, Takeda M, Yamamoto R, et al. Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with Stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy. Cancer. 1999;85(7):1547–54. https://doi.org/10.1002/(sici)1097-0142(19990401)85:7%3c1547::aid-cncr16%3e3.0.co;2-2 .
doi: 10.1002/(sici)1097-0142(19990401)85:7<1547::aid-cncr16>3.0.co;2-2 pubmed: 10193945
Tsai CS, Lai CH, Wang CC, Chang JT, Chang TC, Tseng CJ, et al. The prognostic factors for patients with early cervical cancer treated by radical hysterectomy and postoperative radiotherapy. Gynecol Oncol. 1999;75(3):328–33. https://doi.org/10.1006/gyno.1999.5527 .
doi: 10.1006/gyno.1999.5527 pubmed: 10600284
Olthof EP, Mom CH, Snijders MLH, Wenzel HHB, van der Velden J, van der Aa MA. The prognostic value of the number of positive lymph nodes and the lymph node ratio in early-stage cervical cancer. Acta Obstet Gynecol Scand. 2022;101(5):550–7. https://doi.org/10.1111/aogs.14316 .
doi: 10.1111/aogs.14316 pubmed: 35218205 pmcid: 9564443
Voordeckers M, Vinh-Hung V, Van de Steene J, Lamote J, Storme G. The lymph node ratio as prognostic factor in node-positive breast cancer. Radiother Oncol. 2004;70(3):225–30. https://doi.org/10.1016/j.radonc.2003.10.015 .
doi: 10.1016/j.radonc.2003.10.015 pubmed: 15064006
Kim YS, Kim JH, Yoon SM, Choi EK, Ahn SD, Lee SW, et al. Lymph node ratio as a prognostic factor in patients with stage III rectal cancer treated with total mesorectal excision followed by chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2009;74(3):796–802. https://doi.org/10.1016/j.ijrobp.2008.08.065 .
doi: 10.1016/j.ijrobp.2008.08.065 pubmed: 19289261
Li C, Liu W, Cheng Y. Prognostic significance of metastatic lymph node ratio in squamous cell carcinoma of the cervix. Onco Targets Ther. 2016;9:3791–7. https://doi.org/10.2147/OTT.S97702 .
doi: 10.2147/OTT.S97702 pubmed: 27382315 pmcid: 4922781
Aslan K, Meydanli MM, Oz M, Tohma YA, Haberal A, Ayhan A. The prognostic value of lymph node ratio in stage IIIC cervical cancer patients triaged to primary treatment by radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy. J Gynecol Oncol. 2020;31(1): e1. https://doi.org/10.3802/jgo.2020.31.e1 .
doi: 10.3802/jgo.2020.31.e1 pubmed: 31788991
Fleming ND, Frumovitz M, Schmeler KM, dos Reis R, Munsell MF, Eifel PJ, et al. Significance of lymph node ratio in defining risk category in node-positive early stage cervical cancer. Gynecol Oncol. 2015;136(1):48–53. https://doi.org/10.1016/j.ygyno.2014.11.010 .
doi: 10.1016/j.ygyno.2014.11.010 pubmed: 25451695
Joo JH, Kim YS, Nam JH. Prognostic significance of lymph node ratio in node-positive cervical cancer patients. Medicine. 2018;97(30):e11711. https://doi.org/10.1097/MD.000000000001171 .
doi: 10.1097/MD.000000000001171 pubmed: 30045335 pmcid: 6078754
Widschwendter P, Polasik A, Janni W, de Gregorio A, Friedl TWP, de Gregorio N. Lymph node ratio can better predict prognosis than absolute number of positive lymph nodes in operable cervical carcinoma. Oncol Res Treat. 2020;43(3):87–95. https://doi.org/10.1159/000505032 .
doi: 10.1159/000505032 pubmed: 31935729
Polterauer S, Hefler L, Seebacher V, Rahhal J, Tempfer C, Horvat R, et al. The impact of lymph node density on survival of cervical cancer patients. Br J Cancer. 2010;103(5):613–6. https://doi.org/10.1038/sj.bjc.6605801 .
doi: 10.1038/sj.bjc.6605801 pubmed: 20628380 pmcid: 2938249
Li A, Wang L, Jiang Q, Wu W, Huang B, Zhu H. Risk stratification based on metastatic pelvic lymph node status in stage IIIC1p cervical cancer. Cancer Manag Res. 2020;12:6431–9. https://doi.org/10.2147/CMAR.S253522 .
doi: 10.2147/CMAR.S253522 pubmed: 32801883 pmcid: 7395696
Chen Y, Zhang L, Tian J, Fu X, Ren X, Hao Q. Significance of the absolute number and ratio of metastatic lymph nodes in predicting postoperative survival for the International Federation of Gynecology and Obstetrics stage IA2 to IIA cervical cancer. Int J Gynecol Cancer. 2013;23(1):157–63. https://doi.org/10.1097/IGC.0b013e318277 .
doi: 10.1097/IGC.0b013e318277 pubmed: 23221732
Li Z, Duan H, Guo J, Yang Y, Wang W, Hao M, et al. Discussion on the rationality of FIGO 2018 stage IIIC for cervical cancer with oncological outcomes: a cohort study. Ann Transl Med. 2022;10(2):122. https://doi.org/10.21037/atm-21-6374 .
doi: 10.21037/atm-21-6374 pubmed: 35282078 pmcid: 8848354
Ye Y, Li Z, Kang S, Zhan X, Zhang Y, Xu Y, et al. Impact of different postoperative adjuvant therapies on the survival of early-stage cervical cancer patients with one intermediate-risk factor: a multicenter study of 14 years. J Obstet Gynaecol Res. 2023;49(6):1579–91. https://doi.org/10.1111/jog.15632 .
doi: 10.1111/jog.15632 pubmed: 36916196
Ye Y, Li Z, Kang S, Yang Y, Ling B, Wang L, et al. Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors. BMC cancer. 2023;23(1):421. https://doi.org/10.1186/s12885-023-10801-w .
doi: 10.1186/s12885-023-10801-w pubmed: 37161372 pmcid: 10170857
Zhou J, Wu SG, Sun JY, Liao XL, Li FY, Lin HX, et al. Incorporation of the number of positive lymph nodes leads to better prognostic discrimination of node-positive early stage cervical cancer. Oncotarget. 2017;8(16):26057–65. https://doi.org/10.18632/oncotarget.15220 .
doi: 10.18632/oncotarget.15220 pubmed: 28199962 pmcid: 5432237
Atri M, Zhang Z, Dehdashti F, Lee SI, Ali S, Marques H, et al. Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN6671/GOG0233 trial. Gynecol Oncol. 2016;142(3):413–9. https://doi.org/10.1016/j.ygyno.2016.05.002 .
doi: 10.1016/j.ygyno.2016.05.002 pubmed: 27178725 pmcid: 4993667
Liu B, Gao S, Li S. A Comprehensive comparison of CT, MRI, positron emission tomography or positron emission tomography/ct, and diffusion weighted imaging-MRI for detecting the lymph nodes metastases in patients with cervical cancer: a meta-analysis based on 67 studies. Gynecol Obstet Invest. 2017;82(3):209–22. https://doi.org/10.1159/000456006 .
doi: 10.1159/000456006 pubmed: 28183074
Zigras T, Lennox G, Willows K, Covens A. Early cervical cancer: current dilemmas of staging and surgery. Curr Oncol Rep. 2017;19(8):51. https://doi.org/10.1007/s11912-017-0614-5 .
doi: 10.1007/s11912-017-0614-5 pubmed: 28664470
Ramirez PT, Frumovitz M, Pareja R, Lopez A, Vieira M, Ribeiro R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med. 2018;379(20):1895–904. https://doi.org/10.1056/NEJMoa1806395 .
doi: 10.1056/NEJMoa1806395 pubmed: 30380365
Verleye L, Vergote I, Reed N, Ottevanger PB. Quality assurance for radical hysterectomy for cervical cancer: the view of the European Organization for Research and Treatment of Cancer-Gynecological Cancer Group (EORTC-GCG). Annals of oncology : official journal of the European Society for Medical Oncology. 2009;20(10):1631–8. https://doi.org/10.1093/annonc/mdp196 .
doi: 10.1093/annonc/mdp196 pubmed: 19556323
Cibula D, Planchamp F, Fischerova D, Fotopoulou C, Kohler C, Landoni F, et al. European society of gynaecological oncology quality indicators for surgical treatment of cervical cancer. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2020;30(1):3–14. https://doi.org/10.1136/ijgc-2019-000878 .
doi: 10.1136/ijgc-2019-000878 pubmed: 31900285
Zhou J, Zhang WW, Wu SG, He ZY, Sun JY, Wang Y, et al. The impact of examined lymph node count on survival in squamous cell carcinoma and adenocarcinoma of the uterine cervix. Cancer management and research. 2017;9:315–22. https://doi.org/10.2147/CMAR.S141335 .
doi: 10.2147/CMAR.S141335 pubmed: 28761376 pmcid: 5522663
Kesic V. Management of cervical cancer. Eur J Surg Oncol. 2006;32(8):832–7. https://doi.org/10.1016/j.ejso.2006.03.037 .
doi: 10.1016/j.ejso.2006.03.037 pubmed: 16698223
Ramireza PT, Frumovitza M, Parejab R, Lopezc A, Vieirad MA, Ribeiroe RA. Phase III randomized trial of laparoscopic or robotic versus abdominal radical hysterectomy in patients with early stage cervical cancer: LACC trial. Gynecol Oncol. 2018;149(1):245. https://doi.org/10.1016/j.ygyno.2018.04.552 .
doi: 10.1016/j.ygyno.2018.04.552
Bedford S. Cervical cancer: physiology, risk factors, vaccination and treatment. Br J Nurs. 2009;18(2):80–4. https://doi.org/10.12968/bjon.2009.18.2.37874 .
doi: 10.12968/bjon.2009.18.2.37874 pubmed: 19270604
Huang BX, Fang F. Progress in the study of lymph node metastasis in early-stage cervical cancer. Current medical science. 2018;38(4):567–74. https://doi.org/10.1007/s11596-018-1915-0 .
doi: 10.1007/s11596-018-1915-0 pubmed: 30128863
Salvo G, Odetto D, Pareja R, Frumovitz M, Ramirez PT. Revised 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging: a review of gaps and questions that remain. Int J Gynecol Cancer. 2020;30(6):873–8. https://doi.org/10.1136/ijgc-2020-001257 .
doi: 10.1136/ijgc-2020-001257 pubmed: 32241876
Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143(Suppl 2):22–36. https://doi.org/10.1002/ijgo.12611 .
doi: 10.1002/ijgo.12611 pubmed: 30306584
Pan X, Yang W, Wen Z, Li F, Tong L, Tang W. Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis. J Gynecol Oncol. 2020;31(6): e80. https://doi.org/10.3802/jgo.2020.31.e80 .
doi: 10.3802/jgo.2020.31.e80 pubmed: 33078590 pmcid: 7593229
Ye Y, Zhang G, Li Z, et al. Initial treatment for FIGO 2018 stage IIIC cervical cancer based on histological type: A 14-year multicenter study. Cancer Med. 2023;12(19):19617–32. https://doi.org/10.1002/cam4.6586 .
doi: 10.1002/cam4.6586 pubmed: 37768092 pmcid: 10587947
Nakanishi T, Ishikawa H, Suzuki Y, Inoue T, Nakamura S, Kuzuya K. A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol. 2000;79(2):289–93. https://doi.org/10.1006/gyno.2000.5935 .
doi: 10.1006/gyno.2000.5935 pubmed: 11063659
Kodama J, Seki N, Masahiro S, Kusumoto T, Nakamura K, Hongo A, et al. Prognostic factors in stage IB-IIB cervical adenocarcinoma patients treated with radical hysterectomy and pelvic lymphadenectomy. J Surg Oncol. 2010;101(5):413–7. https://doi.org/10.1002/jso.21499 .
doi: 10.1002/jso.21499 pubmed: 20127891
Wang W, Jia HL, Huang JM, et al. Identification of biomarkers for lymph node metastasis in early-stage cervical cancer by tissue-based proteomics. Br J Cancer. 2014;110(7):1748–58. https://doi.org/10.1038/bjc.2014.92 .
doi: 10.1038/bjc.2014.92 pubmed: 24569473 pmcid: 3974096
Melamed A, Margul DJ, Chen L, et al. Survival after minimally invasive radical hysterectomy for early-stage cervical cancer. N Engl J Med. 2018;379(20):1905–14. https://doi.org/10.1056/NEJMoa1804923 .
doi: 10.1056/NEJMoa1804923 pubmed: 30379613 pmcid: 6464372
Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Further stratification of risk groups in patients with lymph node metastasis after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol. 2010;117(1):53–8. https://doi.org/10.1016/j.ygyno.2009.12.006 .
doi: 10.1016/j.ygyno.2009.12.006 pubmed: 20061005
Kubota S, Kobayashi E, Kakuda M, et al. Retrospective analysis for predictors of parametrial involvement in IB cervical cancer. J Obstet Gynaecol Res. 2019;45(3):679–85. https://doi.org/10.1111/jog.13855 .
doi: 10.1111/jog.13855 pubmed: 30565810
Nanthamongkolkul K, Hanprasertpong J. Predictive factors of pelvic lymph node metastasis in early-stage cervical cancer. Oncol Res Treat. 2018;41(4):194–8. https://doi.org/10.1159/000485840 .
doi: 10.1159/000485840 pubmed: 29562222
Turan T, Kimyon Comert G, Boyraz G, et al. What is the impact of corpus uterine invasion on oncologic outcomes in surgically treated cervical cancer? J Obstet Gynaecol Res. 2021;47(10):3634–43. https://doi.org/10.1111/jog.14953 .
doi: 10.1111/jog.14953 pubmed: 34333801
Wang X, Chen C, Liu P, Li W, Wang L, Liu Y. The morbidity of sexual dysfunction of 125 Chinese women following different types of radical hysterectomy for gynaecological malignancies. Arch Gynecol Obstet. 2018;297(2):459–66. https://doi.org/10.1007/s00404-017-4625-0 .
doi: 10.1007/s00404-017-4625-0 pubmed: 29282516
Chen C, Wang W, Liu P, et al. Survival after abdominal Q-M type B versus C2 radical hysterectomy for early-stage cervical Cancer. Cancer Manag Res. 2019;11:10909–19. https://doi.org/10.2147/CMAR.S220212 . Published 2019 Dec 31.
doi: 10.2147/CMAR.S220212 pubmed: 32021416 pmcid: 6955639

Auteurs

Yanna Ye (Y)

Department of Midwifery, School of Health, Dongguan Polytechnic, Dongguan, 523808, China.
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

Rui Lian (R)

Emergency Department, China-Japan Friendship Hospital, Beijing, 100029, China.

Zhiqiang Li (Z)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

Xiaolin Chen (X)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

Yahong Huang (Y)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

Jilong Yao (J)

Department of Obstetrics and Gynecology, Shenzhen Maternal and Child Health Hospital, Shenzhen, 518028, China.

Anwei Lu (A)

Department of Obstetrics and Gynecology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510086, China.

Jinghe Lang (J)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100193, China.

Ping Liu (P)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. lp2@smu.edu.cn.

Chunlin Chen (C)

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. ccl1@smu.edu.cn.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH