Survival outcomes of low-risk and intermediate-risk stage IB1 cervical cancer patients-Reference-Cited by-同舟云学术

Survival outcomes of low-risk and intermediate-risk stage IB1 cervical cancer patients

Published:2019-02-01 Issue:1 Volume:13 Page:27-32
ISSN:1875-855X
Container-title:Asian Biomedicine
language:en
Short-container-title:

Author:

Vanichtantikul Asama¹,Tantbirojn Patou¹,Manchana Tarinee¹

Affiliation:

1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University , Bangkok 10330 , Thailand

Abstract

Abstract Background Survival for patients with early stage cervical cancer without any high-risk factors treated with radical hysterectomy is excellent. However, there are few data on the survival outcomes for low-risk and intermediate-risk early stage cervical cancer patients. Objective To determine survival outcomes and prognostic factors of low-risk and intermediate-risk stage IB1 cervical cancer patients. Methods Stage IB1 cervical cancer patients with radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. Patients with positive pelvic nodes, parametrial involvement, and positive margin who are classified as high-risk patients were excluded. Patients with squamous cell carcinoma or grade 1–2 adenocarcinoma, tumor size less than 2 cm, no lymphovascular space invasion (LVSI), and depth of stromal invasion (DSI) less than 10 mm were defined as low-risk patients. Survival was evaluated using the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed using Cox proportional-hazards regression. Results There were 82 (42.3%) low-risk patients and 112 (57.7%) intermediate-risk patients. More patients in intermediate risk received adjuvant treatment (3.6% and 14.3%, P = 0.07). Three (3.6%) low-risk patients and 18 (16.1%) intermediate-risk patients had recurrent disease (P = 0.004). At median follow-up of 86 months, 1.2% of low-risk patients and 8.9% of intermediate-risk had cancer-related deaths (P = 0.02). Low-risk patients had significantly better 5-year disease-free survival (98.2% vs 91.1%, P = 0.01) and estimated 5-year overall survival (98.5% vs 91.1%, P = 0.01). DSI more than 10 mm and presence of LVSI were significantly associated with recurrence. However, LVSI was an independent prognostic factor. Conclusion Stage IB1 cervical cancer patients had excellent survival. Low-risk patients had significantly better survival. Presence of LVSI was an independent prognostic factor.

Publisher

Walter de Gruyter GmbH

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