Pretreatment Prognostic Factors in Carcinoma of the Uterine Cervix

Ha, Sung Whan; Oh, Do Hoon; Kim, Mi Sook; Shin, Kyung Hwan; Kim, Jae Sung; Lee, Moo Song; Yoo, Keun Young

Abstract

To identify pretreatment prognostic factors in carcinoma of the uterine cervix, a retrospective analysis was undertaken of 510 patients treated with curative radiation therapy in Seoul National University Hospital during the 7 year period, from March 1979 through December 1986. According to FIGO classification, 35 patients were stage IB, 89 were stage IIA, 232 were stage IIB, 8 were stage IIIA, 134 were III B, and 12 were stage IVA. Five year locoregional control (LRC) rates in stage IB, IIA, IIB, IIIA, IIIB, and IVA were 79%, 78%, 70%, 58%, 51% and 27%, respectively. Five year disease free survival(DFS) rates were 76%, 67%, 60%, 57%, 40%, and 25%, respectively. Overall survival(OS) rates at five years were 82%, 72%, 67%, 67%, 51%, and 33%, respectively. In univariate analyses, stage, age, initial hemoglobin level, type of histology, tumor size, and several CT findings including pelvic lymph node(LN) status, paraaortic lymph node(PAN) status, extent of parametrial invasion, bladder invasion, and rectal invasion were significant factors in terms of overall survival, stage, initial hemoglobin level, type of histology, tumor size, elevation of BUN or creatinine, and five CT findings associated with LRC were prognostically significant. In multivariate analysis excluding CT findings, stage IV disease, non-squamous histology, and tumor size > or=4 cm were associated with poor LRC and DFS. Stage IV disease and tumor size significantly affected OS. In multivariate analysis including CT findings, histology, tumor size, and pelvic LN status on CT were uniformly significant in terms of LRC, DFS, and OS. PAN status on CT affected overall survival only.