J Gynecol Oncol.  2012 Jul;23(3):153-158. 10.3802/jgo.2012.23.3.153.

Tumor volume and lymphovascular space invasion as a prognostic factor in early invasive adenocarcinoma of the cervix

Affiliations
  • 1Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan. fujiit@a5.keio.jp
  • 2Department of Pathology, Keio University School of Medicine, Tokyo, Japan.

Abstract


OBJECTIVE
The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed.
METHODS
The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature.
RESULTS
The median follow-up period was 64.3 months. The depth of stromal invasion was < or =3 mm in 33 cases and >3 mm, but < or =5 mm in 17 cases. The horizontal spread was < or =7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of < or =500 mm3, and three of the 17 cases with tumor volumes of >500 mm3 were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted.
CONCLUSION
Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of < or =5 mm and a tumor volume of < or =500 mm3.

Keyword

Adenocarcinoma; Cervical cancer; Conization; Pathology; Surgery

MeSH Terms

Adenocarcinoma
Cervix Uteri
Conization
Female
Follow-Up Studies
Humans
Lymph Nodes
Neoplasm Metastasis
Recurrence
Tumor Burden
Uterine Cervical Neoplasms

Figure

  • Fig. 1 Diagram of tumor volume measurement calculated using the Burghardt method. Tumor volume was determined using the following equation: depth (D) of stromal invasion×horizontal (H) spread×1.5 greater value of depth or horizontal spread.


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