Prognostic factors of early stage cervical cancer treated by radical hysterectomy

B. U. Sevin, Mehrdad Nadji, B. Lampe, Y. Lu, S. Hilsenbeck, O. R. Koechli, H. E. Averette

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Abstract

Background. This study was performed to identify pathologic and clinical features that best correlate with lymph node metastasis and disease free survival among patients with Stage I and II cervical cancer treated by radical hysterectomy. Methods. Three hundred-seventy patients with complete clinical information and pathologic material, including cone and cervical biopsies, were selected for analysis. Of these patients, 301 with clinical stages I and II disease were the subject of this paper. The results of patients with microinvasive carcinoma of the cervix, as defined by the Society of Gynecologic Oncologists (depth of invasion ≤3 mm and no lymph node vascular space invasion), were reported previously and excluded from this analysis. Patients with small cell carcinoma of the cervix were found to have a very poor prognosis (disease free 5-year survival of 36%) and were also excluded from this analysis (Sevin BU, Nadji M, Metkoch MW, Lu Y, Averette HE. Unpublished data, 1995). Variables studied were patient age, weight, race, marital status, and economic status; tumor size; depth of invasion; lymph node-vascular space involvement; cell type; tumor grade; lymph node metastasis; and number of lymph nodes removed. The influence of these variables on survival was examined by univariate analysis with use of Cox's regression model and the log rank test for comparison of survival curves. Results. Factors that predict disease free survival, ranked by degree of significance, were depth of invasion, tumor size, lymph node-vascular space invasion, number of positive nodes, tumor volume, clinical stage, and tumor extension to the vagina or surgical margins. Conclusions. Radical hysterectomy and bilateral lymphadenectomy is standard therapy for patients with Stage IB and IIA carcinoma of the cervix. A variety of surgically defined risk factors predict 5-year disease free survival, and many of these factors are related. Identification of independent risk factors requires a multivariate analysis of data.

Original languageEnglish
Pages (from-to)1978-1986
Number of pages9
JournalCancer
Volume76
Issue number10 SUPPL.
StatePublished - Jan 1 1995

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Hysterectomy
Uterine Cervical Neoplasms
Lymph Nodes
Cervix Uteri
Disease-Free Survival
Blood Vessels
Survival
Neoplasms
Carbaryl
Neoplasm Metastasis
Carcinoma
Small Cell Carcinoma
Marital Status
Vagina
Tumor Burden
Lymph Node Excision
Proportional Hazards Models
Multivariate Analysis
Economics
Biopsy

Keywords

  • cervical carcinoma
  • disease free survival
  • lymph node metastasis
  • prognostic factors
  • radical hysterectomy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sevin, B. U., Nadji, M., Lampe, B., Lu, Y., Hilsenbeck, S., Koechli, O. R., & Averette, H. E. (1995). Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer, 76(10 SUPPL.), 1978-1986.

Prognostic factors of early stage cervical cancer treated by radical hysterectomy. / Sevin, B. U.; Nadji, Mehrdad; Lampe, B.; Lu, Y.; Hilsenbeck, S.; Koechli, O. R.; Averette, H. E.

In: Cancer, Vol. 76, No. 10 SUPPL., 01.01.1995, p. 1978-1986.

Research output: Contribution to journalArticle

Sevin, BU, Nadji, M, Lampe, B, Lu, Y, Hilsenbeck, S, Koechli, OR & Averette, HE 1995, 'Prognostic factors of early stage cervical cancer treated by radical hysterectomy', Cancer, vol. 76, no. 10 SUPPL., pp. 1978-1986.
Sevin BU, Nadji M, Lampe B, Lu Y, Hilsenbeck S, Koechli OR et al. Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer. 1995 Jan 1;76(10 SUPPL.):1978-1986.
Sevin, B. U. ; Nadji, Mehrdad ; Lampe, B. ; Lu, Y. ; Hilsenbeck, S. ; Koechli, O. R. ; Averette, H. E. / Prognostic factors of early stage cervical cancer treated by radical hysterectomy. In: Cancer. 1995 ; Vol. 76, No. 10 SUPPL. pp. 1978-1986.
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abstract = "Background. This study was performed to identify pathologic and clinical features that best correlate with lymph node metastasis and disease free survival among patients with Stage I and II cervical cancer treated by radical hysterectomy. Methods. Three hundred-seventy patients with complete clinical information and pathologic material, including cone and cervical biopsies, were selected for analysis. Of these patients, 301 with clinical stages I and II disease were the subject of this paper. The results of patients with microinvasive carcinoma of the cervix, as defined by the Society of Gynecologic Oncologists (depth of invasion ≤3 mm and no lymph node vascular space invasion), were reported previously and excluded from this analysis. Patients with small cell carcinoma of the cervix were found to have a very poor prognosis (disease free 5-year survival of 36{\%}) and were also excluded from this analysis (Sevin BU, Nadji M, Metkoch MW, Lu Y, Averette HE. Unpublished data, 1995). Variables studied were patient age, weight, race, marital status, and economic status; tumor size; depth of invasion; lymph node-vascular space involvement; cell type; tumor grade; lymph node metastasis; and number of lymph nodes removed. The influence of these variables on survival was examined by univariate analysis with use of Cox's regression model and the log rank test for comparison of survival curves. Results. Factors that predict disease free survival, ranked by degree of significance, were depth of invasion, tumor size, lymph node-vascular space invasion, number of positive nodes, tumor volume, clinical stage, and tumor extension to the vagina or surgical margins. Conclusions. Radical hysterectomy and bilateral lymphadenectomy is standard therapy for patients with Stage IB and IIA carcinoma of the cervix. A variety of surgically defined risk factors predict 5-year disease free survival, and many of these factors are related. Identification of independent risk factors requires a multivariate analysis of data.",
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AB - Background. This study was performed to identify pathologic and clinical features that best correlate with lymph node metastasis and disease free survival among patients with Stage I and II cervical cancer treated by radical hysterectomy. Methods. Three hundred-seventy patients with complete clinical information and pathologic material, including cone and cervical biopsies, were selected for analysis. Of these patients, 301 with clinical stages I and II disease were the subject of this paper. The results of patients with microinvasive carcinoma of the cervix, as defined by the Society of Gynecologic Oncologists (depth of invasion ≤3 mm and no lymph node vascular space invasion), were reported previously and excluded from this analysis. Patients with small cell carcinoma of the cervix were found to have a very poor prognosis (disease free 5-year survival of 36%) and were also excluded from this analysis (Sevin BU, Nadji M, Metkoch MW, Lu Y, Averette HE. Unpublished data, 1995). Variables studied were patient age, weight, race, marital status, and economic status; tumor size; depth of invasion; lymph node-vascular space involvement; cell type; tumor grade; lymph node metastasis; and number of lymph nodes removed. The influence of these variables on survival was examined by univariate analysis with use of Cox's regression model and the log rank test for comparison of survival curves. Results. Factors that predict disease free survival, ranked by degree of significance, were depth of invasion, tumor size, lymph node-vascular space invasion, number of positive nodes, tumor volume, clinical stage, and tumor extension to the vagina or surgical margins. Conclusions. Radical hysterectomy and bilateral lymphadenectomy is standard therapy for patients with Stage IB and IIA carcinoma of the cervix. A variety of surgically defined risk factors predict 5-year disease free survival, and many of these factors are related. Identification of independent risk factors requires a multivariate analysis of data.

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