Stage IB Carcinoma of the Cervix : Prognostic Factors Related to 5-year Disease Free Survival

Park, J E; Kim, J Y; Kim, J H; Kim, K S; Oh, B C; Kim, J D

Abstract

Radical hysterectomy and pelvic lymph node dissection is well accepted as primary treatment for early stage carcinoma of the cervix. While surgery and radiotherapy achieve similar survival results, surgery may offer additional benefits, including preserved ovarian and sexual function. Patient selection is the key to good results for treatment method of the early stage cervical cancer. This study was undertaken to identify clinicopathological prognostic factors in 70 patients with stage IB carcinoma of the cervix treated by radical surgery with or without adjuvant radiotherapy from January 1985 to December 1991. Prognostic factors included patient age, tumor size, cell type and differentiation, and lymph node metastasis. Tumor size was found to be the only important prognostic factor for 5-year disease free survival rate (P<0.05), and tumor size also correlated significantly with metastasis to lymph nodes (P<0.05). Patient age, tumor cell type, histologic grade, and positive lymph nodes did not significantly affect 5-year disease free survival rate (P>0.05). The recurrence rate was higher in patients with large primary tumor (P<0.05). There was significant difference in recurrence rate between surgery alone and surgery plus postoperative radiotherapy in all patients (P<0.05). In conclusion, these factors are important from a prognostic standpoint but often do not alter the standard therapy of either radiation or radical surgery. As effective adjuvant therapy become available, these prognostic factors will be critical to determine which patients would benefit from adjuvant therapy.