Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer

Koji Matsuo, Muneaki Shimada, Keiichiro Nakamura, Yuji Takei, Kimio Ushijima, Toshiyuki Sumi, Tatsuru Ohara, Hideaki Yahata, Mikio Mikami, Toru Sugiyama

Research output: Contribution to journalArticle

Abstract

Objective: To examine predictors of pathological parametrial invasion in clinical stage IIB cervical cancer, and to examine prognostic factors in pathological stage IIB disease. Methods: This study is an ancillary analysis of a nation-wide retrospective cohort examining 6,003 clinical stage IB-IIB cervical cancers. Women with clinical stage IIB disease who underwent primary radical hysterectomy with lymphadenectomy were examined (n = 714). Multivariate analysis was performed to identify independent clinico-pathological factors for pathological parametrial invasion and to identify independent prognostic factors in pathological stage IIB disease. Results: Parametrial invasion was identified on the surgical specimen in 400 cases (56.0%, 95% confidence interval 52.4–59.7). On multivariate analysis, deep stromal invasion (DSI, adjusted-OR 3.922), multiple pelvic nodal metastases (adjusted-OR 3.266), lympho-vascular space invasion (adjusted-OR 2.333), and uterine corpus invasion (adjusted-OR 1.656) remained independent tumor factors for pathological parametrial invasion. In classification-tree models, tumors with DSI and multiple pelvic nodal metastases had the highest incidence of pathological parametrial invasion (75.0–87.7%); contrary, tumors without DSI had the lowest incidence (21.9%). Among patients with pathological stage IIB disease, the absolute difference in 5-year disease-free survival rates was 57.2%, ranging between 80.9% in those with squamous histology with none/single pelvic nodal metastasis and 23.7% in those with non-squamous histology with multiple pelvic nodal metastases. Conclusion: In clinical stage IIB cervical cancer, accuracy for pathological parametrial invasion is low-modest. With absence of DSI, only one in five clinical stage IIB diseases has pathological stage IIB disease. Survival of pathological stage IIB varies widely and is largely dependent on nodal factors.

Original languageEnglish
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Uterine Cervical Neoplasms
Neoplasm Metastasis
Histology
Multivariate Analysis
Neoplasms
Incidence
Lymph Node Excision
Hysterectomy
Disease-Free Survival
Blood Vessels
Survival Rate
Confidence Intervals
Survival

Keywords

  • Cervical cancer
  • Parametrial invasion
  • Radical hysterectomy
  • Stage IIB
  • Surgical-pathological factor

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer. / Matsuo, Koji; Shimada, Muneaki; Nakamura, Keiichiro; Takei, Yuji; Ushijima, Kimio; Sumi, Toshiyuki; Ohara, Tatsuru; Yahata, Hideaki; Mikami, Mikio; Sugiyama, Toru.

In: European Journal of Surgical Oncology, 01.01.2019.

Research output: Contribution to journalArticle

Matsuo, Koji ; Shimada, Muneaki ; Nakamura, Keiichiro ; Takei, Yuji ; Ushijima, Kimio ; Sumi, Toshiyuki ; Ohara, Tatsuru ; Yahata, Hideaki ; Mikami, Mikio ; Sugiyama, Toru. / Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer. In: European Journal of Surgical Oncology. 2019.
@article{1667264e6c0640349e097c0de801fcf8,
title = "Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer",
abstract = "Objective: To examine predictors of pathological parametrial invasion in clinical stage IIB cervical cancer, and to examine prognostic factors in pathological stage IIB disease. Methods: This study is an ancillary analysis of a nation-wide retrospective cohort examining 6,003 clinical stage IB-IIB cervical cancers. Women with clinical stage IIB disease who underwent primary radical hysterectomy with lymphadenectomy were examined (n = 714). Multivariate analysis was performed to identify independent clinico-pathological factors for pathological parametrial invasion and to identify independent prognostic factors in pathological stage IIB disease. Results: Parametrial invasion was identified on the surgical specimen in 400 cases (56.0{\%}, 95{\%} confidence interval 52.4–59.7). On multivariate analysis, deep stromal invasion (DSI, adjusted-OR 3.922), multiple pelvic nodal metastases (adjusted-OR 3.266), lympho-vascular space invasion (adjusted-OR 2.333), and uterine corpus invasion (adjusted-OR 1.656) remained independent tumor factors for pathological parametrial invasion. In classification-tree models, tumors with DSI and multiple pelvic nodal metastases had the highest incidence of pathological parametrial invasion (75.0–87.7{\%}); contrary, tumors without DSI had the lowest incidence (21.9{\%}). Among patients with pathological stage IIB disease, the absolute difference in 5-year disease-free survival rates was 57.2{\%}, ranging between 80.9{\%} in those with squamous histology with none/single pelvic nodal metastasis and 23.7{\%} in those with non-squamous histology with multiple pelvic nodal metastases. Conclusion: In clinical stage IIB cervical cancer, accuracy for pathological parametrial invasion is low-modest. With absence of DSI, only one in five clinical stage IIB diseases has pathological stage IIB disease. Survival of pathological stage IIB varies widely and is largely dependent on nodal factors.",
keywords = "Cervical cancer, Parametrial invasion, Radical hysterectomy, Stage IIB, Surgical-pathological factor",
author = "Koji Matsuo and Muneaki Shimada and Keiichiro Nakamura and Yuji Takei and Kimio Ushijima and Toshiyuki Sumi and Tatsuru Ohara and Hideaki Yahata and Mikio Mikami and Toru Sugiyama",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.ejso.2019.02.019",
language = "English",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer

AU - Matsuo, Koji

AU - Shimada, Muneaki

AU - Nakamura, Keiichiro

AU - Takei, Yuji

AU - Ushijima, Kimio

AU - Sumi, Toshiyuki

AU - Ohara, Tatsuru

AU - Yahata, Hideaki

AU - Mikami, Mikio

AU - Sugiyama, Toru

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To examine predictors of pathological parametrial invasion in clinical stage IIB cervical cancer, and to examine prognostic factors in pathological stage IIB disease. Methods: This study is an ancillary analysis of a nation-wide retrospective cohort examining 6,003 clinical stage IB-IIB cervical cancers. Women with clinical stage IIB disease who underwent primary radical hysterectomy with lymphadenectomy were examined (n = 714). Multivariate analysis was performed to identify independent clinico-pathological factors for pathological parametrial invasion and to identify independent prognostic factors in pathological stage IIB disease. Results: Parametrial invasion was identified on the surgical specimen in 400 cases (56.0%, 95% confidence interval 52.4–59.7). On multivariate analysis, deep stromal invasion (DSI, adjusted-OR 3.922), multiple pelvic nodal metastases (adjusted-OR 3.266), lympho-vascular space invasion (adjusted-OR 2.333), and uterine corpus invasion (adjusted-OR 1.656) remained independent tumor factors for pathological parametrial invasion. In classification-tree models, tumors with DSI and multiple pelvic nodal metastases had the highest incidence of pathological parametrial invasion (75.0–87.7%); contrary, tumors without DSI had the lowest incidence (21.9%). Among patients with pathological stage IIB disease, the absolute difference in 5-year disease-free survival rates was 57.2%, ranging between 80.9% in those with squamous histology with none/single pelvic nodal metastasis and 23.7% in those with non-squamous histology with multiple pelvic nodal metastases. Conclusion: In clinical stage IIB cervical cancer, accuracy for pathological parametrial invasion is low-modest. With absence of DSI, only one in five clinical stage IIB diseases has pathological stage IIB disease. Survival of pathological stage IIB varies widely and is largely dependent on nodal factors.

AB - Objective: To examine predictors of pathological parametrial invasion in clinical stage IIB cervical cancer, and to examine prognostic factors in pathological stage IIB disease. Methods: This study is an ancillary analysis of a nation-wide retrospective cohort examining 6,003 clinical stage IB-IIB cervical cancers. Women with clinical stage IIB disease who underwent primary radical hysterectomy with lymphadenectomy were examined (n = 714). Multivariate analysis was performed to identify independent clinico-pathological factors for pathological parametrial invasion and to identify independent prognostic factors in pathological stage IIB disease. Results: Parametrial invasion was identified on the surgical specimen in 400 cases (56.0%, 95% confidence interval 52.4–59.7). On multivariate analysis, deep stromal invasion (DSI, adjusted-OR 3.922), multiple pelvic nodal metastases (adjusted-OR 3.266), lympho-vascular space invasion (adjusted-OR 2.333), and uterine corpus invasion (adjusted-OR 1.656) remained independent tumor factors for pathological parametrial invasion. In classification-tree models, tumors with DSI and multiple pelvic nodal metastases had the highest incidence of pathological parametrial invasion (75.0–87.7%); contrary, tumors without DSI had the lowest incidence (21.9%). Among patients with pathological stage IIB disease, the absolute difference in 5-year disease-free survival rates was 57.2%, ranging between 80.9% in those with squamous histology with none/single pelvic nodal metastasis and 23.7% in those with non-squamous histology with multiple pelvic nodal metastases. Conclusion: In clinical stage IIB cervical cancer, accuracy for pathological parametrial invasion is low-modest. With absence of DSI, only one in five clinical stage IIB diseases has pathological stage IIB disease. Survival of pathological stage IIB varies widely and is largely dependent on nodal factors.

KW - Cervical cancer

KW - Parametrial invasion

KW - Radical hysterectomy

KW - Stage IIB

KW - Surgical-pathological factor

UR - http://www.scopus.com/inward/record.url?scp=85062285525&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062285525&partnerID=8YFLogxK

U2 - 10.1016/j.ejso.2019.02.019

DO - 10.1016/j.ejso.2019.02.019

M3 - Article

C2 - 30846298

AN - SCOPUS:85062285525

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

ER -