An Analysis of Clinicopathologic Factors Affecting Survival in Patients with Invasive Cervical Carcinoma

Lee, Yong Seung; Kim, Woo Young; Kim, Ji Un; Park, Chang Soo; Kim, Byoung Gie; Lee, Je Ho; Bae, Duk Soo

Abstract

OBJECTIVE
The aim of this study was to investigate the clinicopathologic characteristics of cervical carcinoma and to evaluate the prognostic factors which have an impact on 5-year survival.
PATIENTS AND METHODS
575 patients with invasive cervical carcinoma treated at Samsung Medical Center from November 1994 to January 2000, for whom the records were retrospectively analyzed, were included in this study. Of the 575 patients, 499 patients were primarily treated by surgery including conization or type I, II, III hysterectomy. Medical records including pathologic reports were reviewed to identify clinicopathologic characteristics. Survival was analyzed by Kaplan-Meier method and log-rank test was used for curve comparison. Cox proportional hazards model was used for multivariate analysis.
RESULTS
The age distribution of patients was from 26 to 84 years old, and the peak incidence was in the 5th decade. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution of invasive cervical cancer was 76.4%, 19.2%, 1.9%, 1.2% for stage I, II, III, IV respectively. Among 354 patients with FIGO stage Ib and II a, 325 patients were treated by type III hysterectomy. The overall 5-year survival of 575 patients was 91.9%, and the 5-year disease-free survival rate (DFSR) according to FIGO stage was as follows: Ia 97.5%, Ib 95.5%, II a 85%, IIb 66.8%, III/IV 42%. The frequency of lymph node metastasis was 10.2% in stage Ib and 25.4% in stage II a. In multivariate analysis, only FIGO stage and lymph node involvement remained independent prognostic factors.
CONCLUSION
This study showed that clinical stage and lymph node involvement status are identified as independent prognostic factors in the patients with cervical cancer.