IMR Press / EJGO / Volume 27 / Issue 6 / pii/2006237

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Surgical pathologic factors in patients with early-stage cervical carcinoma treated with radical hysterectomy and pelvic lymph node dissection: association with administration of adjuvant radiotherapy and effect on survival

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1 Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
2 Department of Epidemiology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eur. J. Gynaecol. Oncol. 2006, 27(6), 573–578;
Published: 10 December 2006
Abstract

Purpose of investigation: To identify surgical pathologic factors that best correlate with administration of adjuvant radiotherapy and best predict survival in early-stage cervical carcinoma treated with radical hysterectomy and pelvic lymph node dissection (RHND). Methods: Data from the files of 126 patients with cervical carcinoma treated by RHND at the Soroka Medical Center from 1962 through 2005 were analyzed. Results: Fifty-four percent of the patients received postoperative adjuvant radiotherapy. In a univariate analysis, each of the fol­lowing factors: positive pelvic lymph nodes, lower uterine segment involvement, lymph vascular space involvement, penetration ≥50% of the cervical wall, grade 2+3, parametrial and/or paracervical involvement, vaginal margin involvement, non-squamous his­tologic type, tumor size ≥3 cm and Stage IB2 + IIA was significantly associated with administration of radiotherapy. In a multi­variate analysis, positiviy of pelvic lymph nodes was persistently the most significant factor associated with administration of radio­therapy. The 5-year survival rate was 82.6% overall. In a univariate analysis, a significant worsening in survival was demonstrated with positivity of pelvic lymph nodes and positivity of lymph vascular space involvement. In a “better fit”model of multivariate analysis, pelvic lymph node status was the strongest and the only significant predictor of survival. Conclusions: In patients with early-stage cervical carcinoma treated with radical hysterectomy and pelvic lymph node dissection, pelvic lymph node status is the strongest factor affecting administration of adjuvant radiotherapy and the most significant predictor of survival.

Keywords
Cervical carcinoma
Prognostic factors
Adjuvant radiotherapy
Survival
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