Clinicopathologic analysis and prognosis of uterine cervical cancer.
- Author:
Myong Cheol LIM
1
;
Seon Kyung LEE
;
Seong Jae PARK
;
Seung Bo KIM
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Kyung Hee University, Seoul, Korea. behappylife@hanmail.net
- Publication Type:Original Article
- Keywords:
Cervix cancer;
Survival rate;
Prognosis
- MeSH:
Adenocarcinoma;
Age Distribution;
Carcinoma, Adenosquamous;
Carcinoma, Squamous Cell;
Drug Therapy;
Follow-Up Studies;
Humans;
Incidence;
Lymph Nodes;
Medical Records;
Multivariate Analysis;
Neoplasm Metastasis;
Pregnancy;
Prognosis*;
Radiotherapy;
Retrospective Studies;
Survival Rate;
Uterine Cervical Neoplasms*
- From:Korean Journal of Obstetrics and Gynecology
2005;48(2):304-313
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The object of this retrospective study was to evaluate the clinical characteristics and prognosis of invasive uterine cervical cancer. METHODS: 445 evaluable patients with invasive cancer of the cervix were treated at Kyung Hee Medical Center from March 1984 to March 1998. In this retrospective study, we studied the clinico-pathologic characteristics (age, FIGO stage, histologic type, nodal metastasis, and treatment modalities et al) by the review of medical records. RESULTS: 1. The age distribution among the 445 patients ranged from 27 to 90 years, mostly at 51-60 years, which occupied 26.5%. The mean age was 48.9 years. 2. The frequent number of pregnancies was 3-4 times, which occupied 33.3%. The mean number of pregnancies was 5.3 times. The frequent number of deliveries was 3-4 times, which occupied 41.7%. The mean number of deliveries was 3.2 times. 3. Subdivision of 445 cases of invasive cervical carcinoma were made according to the FIGO clinical staging: Stage Ia 77 cases (17.3%), Stage Ib 156 cases (35.0%), Stage IIa 95 cases (21.3%), and Stage IIb 52 cases (11.7%), Stage III 40 cases (9.0%), and Stage IV 25 cases (5.6%). 4. Histologically, squamous cell carcinoma comprised 91.2%, adenocarcinoma 6.6%, adenosquamous carcinoma 1.7%, and others 0.5%. 5. The types of treatment were as follows; operation 36.2%, operation with chemoradiation 13.8%, operation with radiotherapy 11.4%, operation with chemotherapy 11.0%, radiation 8.8%, chemoradiation 6.9%, and others 12.0%. 6. All the excised pelvic and para-aortic lymph nodes (LN) were histologically examined and the incidence of metastasis by clinical stage showed as follows. In Stage Ib 16.4%, 2.3%, in Stage IIa 24.5%, 3.2%, and in the stage IIb 26.7%, 6.7% respectively. The most frequently involved LN among regional pelvic LN is the obturator LN (32%) followed by the external iliac LN (29%). 7. Based on the 445 cases who were available to follow up 5 years or more after treatment, survival rates were studied and analyzed. 5 year survival rate by stage revealed 96% in stage Ia, 87.3% in stage Ib, 81.3% in stage IIa, 72% in stage IIb, 47% in stage III, and 26.4% in stage IV. CONCLUSION: FIGO stage, involvement of resection margin, and LN involvement had prognostic significance in multivariate analysis (p<0.01). However, tumor size, histologic type, depth of cervical wall invasion, and lymphovascular space invasion did not.
