Post-CCRT pelvic lymph node size and pathological nodal involvement in cervical cancer
- 1Department of Obstetrics and Gynecology, Okazaki City Hospital, Okazaki, Japan
- 2Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa- ku, Nagoya, 466-8550 Japan
Abstract
Background: Lymph node metastasis is an important prognostic factor in cervical cancer, but assessment of nodal response after concurrent chemoradiotherapy (CCRT) remains difficult. This study evaluated the diagnostic value of post-CCRT lymph node size for predicting pathological nodal involvement using a cohort treated with CCRT followed by planned surgery.
Methods: This retrospective cohort study included 57 patients with cervical cancer who underwent CCRT followed by surgery including pelvic lymphadenectomy. The short- and long-axis diameters of the largest pelvic lymph node were measured on computed tomography before and after CCRT. Histopathological findings of resected lymph nodes were used as the reference standard. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance.
Results: Pathological nodal metastasis was identified in 17 of 57 patients (29.8%). Post-CCRT lymph node diameters were significantly larger in the ypN1 group than in the ypN0 group. The short-axis diameter showed better diagnostic performance than the 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). Among integer cutoff values, the short-axis diameter showed the highest Youden index at 5 mm and the highest F1 score at 7 mm. At a 7-mm cutoff, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 58.8%, 90.0%, 71.4%, 83.7%, and 80.7%, respectively.
Conclusion: Post-CCRT pelvic lymph node size, especially the short-axis diameter, may be useful for estimating residual pathological nodal disease in cervical cancer.
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BibTeX
@article{suzuki2026postccrt,
title = {{Post-CCRT pelvic lymph node size and pathological nodal involvement in cervical cancer}},
author = {Teppei Suzuki and Nobuhisa Yoshikawa and Chitose Kamiya and Komei Katayama and Kazumasa Mogi and Shohei Iyoshi and Kosuke Yoshida and Masato Yoshihara and Yukari Nagao and Satoshi Tamauchi and Akira Yokoi and Kaoru Niimi and Hiroaki Kajiyama},
journal = {International Journal of Clinical Oncology},
year = {2026},
month = aug,
doi = {10.1007/s10147-026-03174-0},
url = {https://doi.org/10.1007/s10147-026-03174-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Post-CCRT pelvic lymph node size and pathological nodal involvement in cervical cancer
AU - Teppei Suzuki
AU - Nobuhisa Yoshikawa
AU - Chitose Kamiya
AU - Komei Katayama
AU - Kazumasa Mogi
AU - Shohei Iyoshi
AU - Kosuke Yoshida
AU - Masato Yoshihara
AU - Yukari Nagao
AU - Satoshi Tamauchi
AU - Akira Yokoi
AU - Kaoru Niimi
AU - Hiroaki Kajiyama
PY - 2026
DA - 2026/08/19
JO - International Journal of Clinical Oncology
DO - 10.1007/s10147-026-03174-0
UR - https://doi.org/10.1007/s10147-026-03174-0
AB - Background: Lymph node metastasis is an important prognostic factor in cervical cancer, but assessment of nodal response after concurrent chemoradiotherapy (CCRT) remains difficult. This study evaluated the diagnostic value of post-CCRT lymph node size for predicting pathological nodal involvement using a cohort treated with CCRT followed by planned surgery. Methods: This retrospective cohort study included 57 patients with cervical cancer who underwent CCRT followed by surgery including pelvic lymphadenectomy. The short- and long-axis diameters of the largest pelvic lymph node were measured on computed tomography before and after CCRT. Histopathological findings of resected lymph nodes were used as the reference standard. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance. Results: Pathological nodal metastasis was identified in 17 of 57 patients (29.8%). Post-CCRT lymph node diameters were significantly larger in the ypN1 group than in the ypN0 group. The short-axis diameter showed better diagnostic performance than the 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). Among integer cutoff values, the short-axis diameter showed the highest Youden index at 5 mm and the highest F1 score at 7 mm. At a 7-mm cutoff, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 58.8%, 90.0%, 71.4%, 83.7%, and 80.7%, respectively. Conclusion: Post-CCRT pelvic lymph node size, especially the short-axis diameter, may be useful for estimating residual pathological nodal disease in cervical cancer.
SN - 1341-9625
SN - 1437-7772
ER -