Overall 5-year survival rate and prognostic factors in patients with stage IB and IIA cervical cancer treated by radical hysterectomy and pelvic lymph node dissection

Abstract

The objective of this paper was to analyze the 5-year survival rate and prognostic factors for stage Ib and IIa cervical cancer treated by radical hysterectomy. A total of 366 patients with invasive cervical cancer treated by radical hysterectomy from June 1985 to June 1994 at Chonnam National University Hospital, Kwangju, Korea were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier estimator. Multivariate analysis was performed using the Cox proportional hazards regression model. The overall 5-year survival rate was 92% in stage Ib and 87% in stage IIa. Factors assessed for prognostic value included age, FIGO stage, cell type, tumor size, depth of invasion, lymphovascular space invasion (LVSI), and pelvic lymph node metastases (LNM). In the multivariate analysis, age, cell type, and lymph node metastases were independent predictors of survival. Lower survival was associated with age greater than 50 years, adenocarcinoma, and presence of lymph node metastases. The higher survival rates in patients with single lymph node involvement or lymph node metastases below the level of the common iliac nodes (85 and 84.6%, respectively) versus multiple or extrapelvic lymph node metastases (50 and 20%, respectively) were statistically significant (P < 0.01). In conclusion, patients who had lymph node metastases, adenocarcinoma, and were older than 50 years had a poorer survival rate. Such patients require more intense postoperative treatment and closer surveillance. Low-risk patients with a single lymph node metastasis below the level of the common iliac nodes may benefit from thorough lymphadenectomy without adjuvant therapy to prevent unpleasant complications.

Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

“…The complication rates are low compared with those for radical hysterectomy 17 as are the recurrence rates. 17 The data are comparable with other published series, with five (4.1%) recurrences and four (3.3%) deaths in 123 women who were selected to have trachelectomy (Table 5). Excluding those who had abandoned procedures or completion treatment, there were three (2.7%) recurrences and two (1.8%) deaths in 112 women.…”

Comparison of outcomes between squamous cell carcinoma and adenocarcinoma in patients with surgically treated stage I–II cervical cancer

“…The prognostic significance of AD histology remains unclear. It was previously reported that AD is less curable and associated with a shorter survival compared to SCC (7)(8)(9)(10)(11), whereas other studies reported no significant differences in prognosis between AD and SCC (12)(13)(14)(15)(16). Notably, the prognostic implications of applying the same treatment strategies on AD as for SCC have not been extensively investigated.…”

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

“…The prognosis of patients with AdCa after RH is unclear, primarily because studies have been performed on small numbers of patients. Some of these studies found that patients with AdCa have poorer prognosis than do those with SCCa (Hopkins and Morley, 1991;Eifel et al, 1995;Look et al, 1996;Samlal et al, 1997;Lai et al, 1999;Kim et al, 2000;Nakanishi et al, 2000), whereas other reports found no differences in prognosis (AntonCulver et al, 1992;Miller et al, 1993;Shingleton et al, 1995;Grisaru et al, 2001;Ayhan et al, 2004;Lee et al, 2006;Fregnani et al, 2008;Kasamatsu et al, 2009). Therefore, the prognosis after RH and the optimal management of AdCa are still a subject of debate.…”