Abstract
OBJECTIVE: This study aims to explore the prognostic factors including the number of examined lymph nodes (ELNs) for elderly cervical cancer patients who have undergone surgery, and to develop and validate a novel model to predict survival prognosis in this patient population. METHODS: A database comprising patients aged 65 years or older diagnosed with stage I-IVA cervical cancer who subsequently underwent surgery was retrieved from the Surveillance, Epidemiology, and End Results Program (SEER). Cox regression analyses were conducted to examine the relationship between the number of ELNs and overall survival (OS). Propensity score matching(PSM) was conducted to control the influence of confounding factors and competitive risk analyses were used to evaluate the relationship between ELN and cervical cancer-specific mortality. A nomogram was constructed based on the training set and validated using the testing set. RESULTS: Eight hundred and seven participants were included totally. Kaplan-Meier survival analysis demonstrated that patients with a higher number of ELNs had significantly prolonged OS. Cox regression analysis confirmed that the number of ELNs was an independent prognostic factor for OS. After PSM, the competitive risk analysis revealed no significant association between the number of ELNs and the risk of cervical cancer specific mortality. A predictive model incorporating variables including the ELNs count, age, FIGO staging, and radiotherapy status was developed, evaluated, and validated to predict survival rate. The model demonstrated high predictive accuracy for survival outcomes. CONCLUSION: The ELN count is a prognostic factor worth considering in elderly patients with cervical cancer and our survival rate prediction model integrating ELN count has good predictive ability and universality.