Risk Factors of Lymph Node Metastasis in Early-stage Cervical Cancer Patients and Build of A Nomogram Prediction Model

Objective To explore the relationship between clinicopathological characteristics and lymph node metastasis in early-stage cervical cancer patients, and to establish a nomogram model to predict lymph node metastasis in early-stage cervical cancer patients undergoing radical hysterectomy without lymphadenectomy.

Methods We retrospectively analyzed clinical pathological data of 432 patients with early-stage cervical cancer undergoing hysterectomy and lymphadenectomy in the First Affiliated Hospital of Fujian Medical University. Logistic regression analysis was used to determine the risk factors for lymph node metastasis of early-stage cervical cancer. A nomogram model for predicting the risk of lymph node metastasis was established, and the predictive performance and compliance of the model were evaluated using the consistency index (C-index) and the calibration curve.

Results Among 432 patients with early-stage cervical cancer, 84 patients had lymph node metastasis, with a positive rate of 19.4%. Multivariate analysis showed tumor diameter>3cm, parametrial spread and lymphovascular space invasion were high risk factors for lymph node metastasis of early-stage cervical cancer; OR values were 1.98(95%CI: 1.17-3.34), 2.64(95%CI: 1.28-5.44) and 4.77(95%CI: 2.60-8.75). The accuracy of nomogram used to predict the risk of lymph node metastasis was 0.687.

Conclusion A nomogram, constructed based on tumor diameter>3cm, parametrial spread and lymphovascular space invasion, could be used to guide if further treatment is required for early-stage cervical cancer patients who have undergone radical hysterectomy without lymphadenectomy.