Prognostic factors in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy

Junichi Kodama, Noriko Seki, Keiichiro Nakamura, Atsushi Hongo, Yuji Hiramatsu

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective.: The purpose of the present study was to identify prognostic factors and recurrent patterns in pathologic parametrium-positive patients with stage IB-IIB cervical cancers treated by radical surgery and adjuvant therapy. Methods.: The patient population consisted of 84 individuals presenting with stage IB-IIB cervical cancers and histologically proven parametrial invasion. All these patients were treated postoperatively with adjuvant external whole pelvic irradiation, combination chemotherapy, or chemoradiotherapy. Results.: The 5-year disease-free survival rate was found to be 67.2% and 5-year overall survival rate, 75.4%. Multivariate analysis revealed that vaginal invasion (p = 0.0008), lymph node metastasis (p = 0.002), and non-squamous histology (p = 0.010) were independent indicators of the disease-free survival rates and that the vaginal invasion (p = 0.009) and lymph node metastasis (p = 0.011) were independent prognostic factors for the overall survival rates. The 5-year overall survival rate was approximately 90% for patients without these risk factors. Disease recurrence was observed in 26 patients (31.0%) with a median time of 16.5 months (range, 5-59 months) from the surgery. Hematogenous recurrences, including those in the lung, liver, and bone, were significantly higher in patients with non-squamous cell carcinomas (p = 0.008). Distant lymph node recurrences were significantly higher in patients with positive pelvic lymph node and vaginal invasion (p = 0.004 and p = 0.023, respectively). Pelvic recurrences were significantly higher in patients with vaginal invasion (p = 0.026). Conclusions.: Vaginal invasion and lymph node metastasis are independent indicators for disease-free and overall survival rates in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy. The survival rate is excellent in the patients without these risk factors. Hematogenous recurrence may be evident in patients with non-squamous cell carcinomas.

Original languageEnglish
Pages (from-to)757-761
Number of pages5
JournalGynecologic Oncology
Volume105
Issue number3
DOIs
Publication statusPublished - Jun 2007

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Peritoneum
Uterine Cervical Neoplasms
Survival Rate
Lymph Nodes
Recurrence
Therapeutics
Disease-Free Survival
Neoplasm Metastasis
Carcinoma
Chemoradiotherapy
Combination Drug Therapy
Histology
Multivariate Analysis
Bone and Bones
Lung

Keywords

  • Cervical cancer
  • Lymph node metastasis
  • Parametrial invasion
  • Prognosis
  • Vaginal invasion

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Prognostic factors in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy. / Kodama, Junichi; Seki, Noriko; Nakamura, Keiichiro; Hongo, Atsushi; Hiramatsu, Yuji.

In: Gynecologic Oncology, Vol. 105, No. 3, 06.2007, p. 757-761.

Research output: Contribution to journalArticle

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title = "Prognostic factors in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy",
abstract = "Objective.: The purpose of the present study was to identify prognostic factors and recurrent patterns in pathologic parametrium-positive patients with stage IB-IIB cervical cancers treated by radical surgery and adjuvant therapy. Methods.: The patient population consisted of 84 individuals presenting with stage IB-IIB cervical cancers and histologically proven parametrial invasion. All these patients were treated postoperatively with adjuvant external whole pelvic irradiation, combination chemotherapy, or chemoradiotherapy. Results.: The 5-year disease-free survival rate was found to be 67.2{\%} and 5-year overall survival rate, 75.4{\%}. Multivariate analysis revealed that vaginal invasion (p = 0.0008), lymph node metastasis (p = 0.002), and non-squamous histology (p = 0.010) were independent indicators of the disease-free survival rates and that the vaginal invasion (p = 0.009) and lymph node metastasis (p = 0.011) were independent prognostic factors for the overall survival rates. The 5-year overall survival rate was approximately 90{\%} for patients without these risk factors. Disease recurrence was observed in 26 patients (31.0{\%}) with a median time of 16.5 months (range, 5-59 months) from the surgery. Hematogenous recurrences, including those in the lung, liver, and bone, were significantly higher in patients with non-squamous cell carcinomas (p = 0.008). Distant lymph node recurrences were significantly higher in patients with positive pelvic lymph node and vaginal invasion (p = 0.004 and p = 0.023, respectively). Pelvic recurrences were significantly higher in patients with vaginal invasion (p = 0.026). Conclusions.: Vaginal invasion and lymph node metastasis are independent indicators for disease-free and overall survival rates in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy. The survival rate is excellent in the patients without these risk factors. Hematogenous recurrence may be evident in patients with non-squamous cell carcinomas.",
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T1 - Prognostic factors in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy

AU - Kodama, Junichi

AU - Seki, Noriko

AU - Nakamura, Keiichiro

AU - Hongo, Atsushi

AU - Hiramatsu, Yuji

PY - 2007/6

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N2 - Objective.: The purpose of the present study was to identify prognostic factors and recurrent patterns in pathologic parametrium-positive patients with stage IB-IIB cervical cancers treated by radical surgery and adjuvant therapy. Methods.: The patient population consisted of 84 individuals presenting with stage IB-IIB cervical cancers and histologically proven parametrial invasion. All these patients were treated postoperatively with adjuvant external whole pelvic irradiation, combination chemotherapy, or chemoradiotherapy. Results.: The 5-year disease-free survival rate was found to be 67.2% and 5-year overall survival rate, 75.4%. Multivariate analysis revealed that vaginal invasion (p = 0.0008), lymph node metastasis (p = 0.002), and non-squamous histology (p = 0.010) were independent indicators of the disease-free survival rates and that the vaginal invasion (p = 0.009) and lymph node metastasis (p = 0.011) were independent prognostic factors for the overall survival rates. The 5-year overall survival rate was approximately 90% for patients without these risk factors. Disease recurrence was observed in 26 patients (31.0%) with a median time of 16.5 months (range, 5-59 months) from the surgery. Hematogenous recurrences, including those in the lung, liver, and bone, were significantly higher in patients with non-squamous cell carcinomas (p = 0.008). Distant lymph node recurrences were significantly higher in patients with positive pelvic lymph node and vaginal invasion (p = 0.004 and p = 0.023, respectively). Pelvic recurrences were significantly higher in patients with vaginal invasion (p = 0.026). Conclusions.: Vaginal invasion and lymph node metastasis are independent indicators for disease-free and overall survival rates in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy. The survival rate is excellent in the patients without these risk factors. Hematogenous recurrence may be evident in patients with non-squamous cell carcinomas.

AB - Objective.: The purpose of the present study was to identify prognostic factors and recurrent patterns in pathologic parametrium-positive patients with stage IB-IIB cervical cancers treated by radical surgery and adjuvant therapy. Methods.: The patient population consisted of 84 individuals presenting with stage IB-IIB cervical cancers and histologically proven parametrial invasion. All these patients were treated postoperatively with adjuvant external whole pelvic irradiation, combination chemotherapy, or chemoradiotherapy. Results.: The 5-year disease-free survival rate was found to be 67.2% and 5-year overall survival rate, 75.4%. Multivariate analysis revealed that vaginal invasion (p = 0.0008), lymph node metastasis (p = 0.002), and non-squamous histology (p = 0.010) were independent indicators of the disease-free survival rates and that the vaginal invasion (p = 0.009) and lymph node metastasis (p = 0.011) were independent prognostic factors for the overall survival rates. The 5-year overall survival rate was approximately 90% for patients without these risk factors. Disease recurrence was observed in 26 patients (31.0%) with a median time of 16.5 months (range, 5-59 months) from the surgery. Hematogenous recurrences, including those in the lung, liver, and bone, were significantly higher in patients with non-squamous cell carcinomas (p = 0.008). Distant lymph node recurrences were significantly higher in patients with positive pelvic lymph node and vaginal invasion (p = 0.004 and p = 0.023, respectively). Pelvic recurrences were significantly higher in patients with vaginal invasion (p = 0.026). Conclusions.: Vaginal invasion and lymph node metastasis are independent indicators for disease-free and overall survival rates in pathologic parametrium-positive patients with stage IB-IIB cervical cancer treated by radical surgery and adjuvant therapy. The survival rate is excellent in the patients without these risk factors. Hematogenous recurrence may be evident in patients with non-squamous cell carcinomas.

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KW - Lymph node metastasis

KW - Parametrial invasion

KW - Prognosis

KW - Vaginal invasion

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