Radical Hysterectomy in Uterine Cervical Carcinoma: Analysis of Prognostic Factors

Shin, Min Jae; Kang, Jae Seong

Abstract

OBJECTIVE
The purpose of this study was to analyze the prognostic factors for patients with cervical carcinoma who had undergone primary radical hysterectomy.
METHODS
The subjects of this study consisted of 75 patients with cervical carcinoma who had undergone radical hysterectomy and pelvic lymphadenectomy. The surgery was performed by a gynecologist at Korea University Hospital and patients were followed up for 5 to 10 years. In a retrospective study of 75 patients with cervical cancer stages I-II, they were treated with radical hysterectomy and/or adjuvant radiotherapy.
RESULTS
The age distribution of patients was from 28 to 65 years old. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution of invasive cervical carcinoma was 32%, 46.6%, 14.7%, 6.7% for stages Ia, Ib, IIa, and IIb, respectively. The five-year survival rate based on the age at diagnosis was as follows: 100% for less than 45 years old, 91.3% for more than 45 years old. The overall incidence of lymph node metastasis was 14.6%. The frequency of lymph node metastasis was 0.0% for stage Ia, 14.3% for stage Ib, 27.3% for stage IIa, and 60.0% for stage IIb. The five-year survival rate was as follows: 100% for stage Ia, 97.1% for stage Ib, 90.9% for stage IIa, and 60.0% for stage IIb. The tumor size also was correlated with survival. The five-year survival rate according to the size of tumor was as follows: 100% for less than 1 cm, 97.7% for 1 cm to 3 cm, 83.3% for 3 cm to 5 cm, 75.0% for more than 5 cm. We estimated survival curves according to different prognostic factors. Age (p=0.033), pelvic lymph node metastasis (p<0.001), initial tumor size (p=0.006) and stage (p=0.002) showed significant correlation with survival.
CONCLUSION
Our study showed that age, clinical stage, lymph node involvement and initial tumor size are identified as independent prognostic factors in the patients with cervical carcinoma.