Twelve years experience with radical hysterectomy and pelvic lymphadenectomy in early stage cervical cancer

Abstract

The objective of this study was to evaluate the outcome, prognostic factors and complications of early stage cervical cancer patients treated with radical hysterectomy and pelvic lymphadenectomy (RHPL). The medical records of cervical cancer patients undergoing RHPL at Chiang Mai University Hospital over 12 years, between January 1995 and December 2006 were reviewed. There were 1,253 patients in the study period. The mean age was 44 years of age. Of these, 26.9% had prior diagnostic conisation. The maximum tumour size was 8 cm. The most common histology was squamous cell carcinoma (67%) followed by adenocarcinoma (23%). The distribution of FIGO staging was: stage IA 8.7%; stage IB 15.8%; stage IB1 61%; stage IB2 6.2%; and stage IIA 8.5%. Pelvic nodes, parametrial and vaginal margin involvement were detected in 15.9%, 10.7% and 3.8% of the patients, respectively. A total of 66.5% of patients underwent RHPL without adjuvant treatment; 12.1% received neoadjuvant chemotherapy. The estimated 10-year recurrence-free survival rate was 90%. Stage IB2/IIA, non-squamous cell carcinoma, nodal involvement and positive vaginal margins were independent, significant, poor prognostic factors. The most common long-term complication was lymphoedema. It was concluded that early stage cervical cancer patients treated with RHPL have long-term favourable outcome with minimal morbidity. Stage IB2 and IIA, non-squamous cell carcinoma, nodal and vaginal involvement were independent adverse prognostic factors.

Prognostic Parameters for Patients with Cervical Cancer FIGO Stages IA2-IIB: A Long-Term Follow-Up

“…This was also demonstrated by the present study, which identified statistically significant differences in 10-year disease-free survival rates and overall survival rates between FIGO stages I and II by univariate and multivariate analyses. Although the 10-year disease-free survival rates were slightly lower than those reported by Suprasert et al [8] , the material analyzed in the present study was based on early-stage neoplasms.…”

“…On the other hand, only a few reports have discussed the long-term observations of those patients [7][8][9][10] . Moreover, the majority of publications have focused on general trends in survival rates without exploring the clinical and pathologic aspects [7,9,10] .…”

Prognostic Value of Pathological Characteristics of Invasive Margins in Early-stage Squamous Cell Carcinomas of the Uterine Cervix

“…The effective current treatment policy contributes to a reduction in recurrence rate and an improvement in survival of early-stage cervical cancer patients (Suprasert et al, 2010). The improved clinical outcomes in the patients who received adjuvant therapy may result in the disappearance of prognostic significance of several well-established pathological variables (e.g.…”

Prognostic Model in Patients with Early-stage Squamous Cell Carcinoma of the Uterine Cervix: A Combination of Invasive Margin Pathological Characteristics and Lymphovascular Space Invasion

“…In this study, a spray-like pattern and LVSI are the two variables with highest impact on tumor recurrence when compared with the other clinicopathological variables which have been recognized as potential prognostic factors in early-stage cervical cancer (Delgado et al, 1990;Yuan et al, 1998;Sedlis et al, 1999;Suprasert et al, 2010). The lack of prognostic values of several well-recognized high-risk pathological variables (e.g.…”

“…Several pathologic features have been extensively studied and recognized as standard prognostic features such as extent of tumor invasion, presence of lymphovascular space invasion (LVSI), parametrial involvement, and lymph node metastasis (Biewenga et al, 2009;2011;Suprasert et al, 2010). The pathologic characteristics at the invasive margin (tumor front) were found to provide prognostic information in several types of cancers, including the uterine cervix (Bryne et al, 1998;Kristensen et al, 1999;Horn et al, 2006a;Eggen et al, 2007).…”