Prognostic factors of stage IB and IIA carcinoma of the cervix treated by surgery.
- Author:
Wen-Hua ZHANG
1
;
Ling-Ying WU
;
Ping BAI
;
Shu-Min LI
;
Rong ZHANG
;
Bin LI
;
Jian-Heng SUN
;
Ai-Ru WU
Author Information
- Publication Type:Journal Article
- MeSH: Adenocarcinoma; pathology; surgery; Adolescent; Adult; Aged; Carcinoma, Squamous Cell; pathology; surgery; Chemotherapy, Adjuvant; Female; Humans; Hysterectomy; Lymph Node Excision; Lymphatic Metastasis; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pregnancy; Pregnancy Complications, Neoplastic; pathology; surgery; Prognosis; Radiotherapy, Adjuvant; Survival Rate; Tumor Burden; Uterine Cervical Neoplasms; pathology; surgery
- From: Chinese Journal of Oncology 2004;26(8):490-492
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate prognostic factors in patients with stage IB-IIA of cervical carcinoma treated by surgery.
METHODSBetween December 1992 and December 2001, 111 patients with stage IB-IIA cervical cancer surgically treated were analyzed. Median age 40 years. According to 1994 FIGO Staging System: IB 80 (IB1 40, IB2 40) and IIA 31. There were 93 cases of squamous cell carcinoma (83.5%), 17 cases of adenocarcinoma (15.3%) and one case of small cell carcinoma. All patients were treated by radical hysterectomy and pelvic lymphadenectomy, 74 patients had preoperative adjuvant radiotherapy, 24 patients had postoperative adjuvant treatment. Kaplan-Meier method was used to evaluate the survival, the related prognostic factors were assessed by Cox regression and chi(2) test.
RESULTSThe overall 5-year survival rate was 85.9%, being 89.1%, 90.7% and 78.4% for stage IB1, IB2 and IIA, respectively. Univariate analysis showed that tumor size (hazards ratio [HR] = 1.479, P = 0.152), tumor type (HR = 1.440, P = 0.264), clinical stage (HR = 1.380, P = 0.354), adjuvant treatment (HR = 1.210, P = 0.450), lymph node metastasis (HR = 1.432, P = 0.540), endocervical involvement (HR = 2.244, P = 0.036), depth of myometrial invasion (HR = 3.295, P = 0.06) and multiple sexual partners during pregnancy (HR = 10.172, P = 0.000) were of prognostic significance. The latter two were the most important factors indicative of poor prognosis.
CONCLUSIONThe depth of myometrial invasion and multi-partners combined with pregnancy are closely related to the prognosis while the pre- and/or postoperative adjuvant therapy should be considered for stage IB-IIA cervical cancer with deep myometrial invasion and in pregnant patients with multiple sexual partners.