TY - JOUR
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
Y1 - 2007/6
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.
KW - Cervical cancer
KW - Lymph node metastasis
KW - Parametrial invasion
KW - Prognosis
KW - Vaginal invasion
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UR - http://www.scopus.com/inward/citedby.url?scp=34248357290&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2007.02.019
DO - 10.1016/j.ygyno.2007.02.019
M3 - Article
C2 - 17433424
AN - SCOPUS:34248357290
VL - 105
SP - 757
EP - 761
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -