Clinical and pathological characteristics related to parametrial involvement in clinical early-stage cervical cancer

Abstract

Objectives: Since parametrial involvement is believed to be a crucial factor in the management of cervical cancer, our study was designed to investigate the clinical and pathological features which predicted parametrial involvement in patients with clinical early-stage cervical cancer. Material and methods:The study included patients with clinical early-stage cervical cancer who underwent radical hysterectomy with pelvic and para-aortic lymphadenectomy between December 2001 and August 2014, at the Hacettepe University Hospital. The clinical and pathological characteristics of the affected patients were evaluated, including age, histologic subtype, tumor size, depth of cervical stromal invasion, lympho-vascular space invasion (LVSI), and lymph node metastasis. Univariate and multivariate analyses were performed to reveal factors associated with parametrial involvement. Results:The study group consisted of 126 patients (mean age: 52.7 years; range: 29-83), including 101 (80.2%) with squamous, 19 (15.1%) with adenocarcinoma, and 6 (4.8%) with adenosquamous histological subtype of cervical cancer. Parametrial involvement and lymph node metastasis were detected in 41 (32.5%) and 46 (36.5%) women, respectively. Univariate analysis showed that deep cervical stromal invasion, LVSI, tumor size > 2 cm and lymph node metastasis were associated with parametrial involvement. Multivariate logistic regression analysis identified the independent risk factors associated with parametrial involvement as LVSI (OR 8.93, 95% CI 1.1-73.5, p = 0.042) and lymph node metastasis (OR 8.8, 95% CI 1.5-9.3, p = 0.004).Conclusions: LVSI, deep cervical stromal invasion, lymph node metastasis and tumor size are significantly associated with parametrial involvement in patients with clinical early-stage cervical cancer.

Less radical surgery for women with early stage cervical cancer: Our experience on radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy

“…We do not exclude patients with tumour size more than 2cms. We agree with authors reporting that the incidence of parametrial involvement in women with a tumour size of <2 cm is 0.6%, but it increases with larger cancer size (Boyraz et al, 2016). Other clinicians have also suggested that infiltration of less than half of the cervical stroma is the limit for a safe trachelectomy (Bentivegna et al, 2016).…”

Risk Assessment of Bone Metastasis for Cervical Cancer Patients by Multiple Models: A Large Population Based Real-World Study

“…However, the bone manifestation is rare in cervical cancer patients. The rates of bone metastasis in cervical cancer patients with early-stage and advanced stage were reported from 4.0 to 22.9% (16)(17)(18)(19). As for bone metastasis, vertebral column is the most frequent site, particularly the lumbar spine (20).…”

Validation of the FIGO 2018 staging system of cervical cancer: Retrospective analysis of FIGO 2009 stage IB1 cervical cancer with tumor under 2 cm

“…In this study, among the cases that were classified as stage IA in the FIGO 2018 classification, only one case (11.1%) had LVSI, and no cases had parametrial invasion; this is compatible with previous reports. The presence of LVSI is considered to be associated with parametrial invasion 17 and lymph node metastasis 18 . Thus, pathological findings including LVSI and tumor size seem to be important for accurately diagnosing the stage and estimating the prognosis before hysterectomy, particularly for small tumors.…”