Prognostic factors of cervical cancer stage IB2 treated surgically

Oh, Hea Young; Jun, Sung Wook; Rho, Hyun Suk; Lee, Kwang Beom; Shin, Jin Woo; Lee, Jong Min; Park, Chan Yong

Abstract

OBJECTIVE
This study was performed to identify pathologic and clinical risk factors that predicted survival in cervical cancer stage IB2 patients treated surgically.
METHODS
The records of 52 patients with cervical cancer IB2 who underwent radical hysterectomy with pelvic lymph node dissection from 1997 to 2003 were reviewed retrospectively. Clinical and pathologic variables included age, tumor size (TS), histologic type, involvement of resection margin, parametrium invasion, lymph node metastasis (LN), lymph-vascular space invasion, depth of invasion, treatment modality and adjuvant radiation therapy (RTx). Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model.
RESULTS
In the present study, median follow up was 46.5 months. With regard to the 2-year disease free survival rate and the 5-year survival rate, univariate analysis revealed no significant differences in subgroups according to age, histologic type, resection margin, parametrium, lymph-vascular space invasion, depth of invasion and treatment modality. Tumor size (p=0.0024), lymph node metastasis (p=0.0007) and radiation therapy (p=0.0398) significantly affected the 2-year disease free survival rate in univariate analysis. They (TS: p=0.0001, LN: p=0.0023, RTx: p=0.0428) also significantly affected 5-year survival rate in univariate analysis. Tumor size (RR 35.87, CI 2.94-438.26, p=0.01) and lymph node metastasis (RR 16.6, CI 1.36-202.05, p=0.03) affected 5-year survival rate in multivariate analysis.
CONCLUSION
In patients with cervical cancer stage IB2 who underwent operation regardless adjuvant radiation therapy, the important independent prognostic factors were tumor size and LN metastasis.