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IMR Press / EJGO / Volume 42 / Issue 3 / DOI: 10.31083/j.ejgo.2021.03.2300
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Open Access Original Research
Clinicopathological features and prognostic factors for survival and lymph node metastases in stage IB adenocarcinoma of the cervix
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1 Department of Gynecological Oncology Surgery, Cancer Hospital Affiliated to Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210000 Nanjing, Jiangsu, China
Eur. J. Gynaecol. Oncol. 2021, 42(3), 450–456; https://doi.org/10.31083/j.ejgo.2021.03.2300
Submitted: 1 November 2020 | Revised: 25 December 2020 | Accepted: 13 January 2021 | Published: 15 June 2021
Abstract

Purpose: To compare the clinicopathological characteristics of patients with stage IB adenocarcinoma (AC) of the cervix and to determine the risk factors for survival and lymph node metastasis. Methods: We retrospectively analyzed 83 patients with stage IB cervical AC treated between 2011 and 2018. The Silva Classification was used to classify all specimens. Kaplan-Meier method was used for survival analysis and Cox regression model used for univariate and multivariate analysis of prognostic factors for survival. A binary logistic regression model was used for the univariate and multivariable analysis of the risk factors for lymph node metastasis. Results: The median follow-up was 45 months (range from 9 to 95 months). A total of 64 (77.12%) patients had stage IB1 and 19 (22.89%) stage IB2. Six patients had recurrence, out of which, 5 died. Univariate analysis revealed that only LVSI (P = 0.001) was a significant prognostic factor. Multivariate analysis showed that LVSI (P = 0.037) was also the only independent significant prognostic factor. By univariate analysis, grade 3 (P = 0.04), LVSI (P $<$ 0.001), depth of stromal invasion $\geq$10 mm (P = 0.049), Silva C (P $<$ 0.001) were significant risk factors for lymph node metastasis. Multivariate analysis showed that LVSI (P = 0.03) and Silva C (P = 0.023) were the independent risk factors for lymph node metastasis. Conclusions: For stage IB AC, LVSI was the only independent prognostic factor for survival. LVSI and Silva C were the independent risk factors for lymph node metastasis.

Keywords
Prognostic factor