Squamous cell cancer of the cervix: prognostic factors related to survival

Abstract

Seven hundred and fifty-three patients with invasive squamous cell cancer of the cervix treated at the University of Michigan from 1970–1985 are reported. These included stage IA 43, stage IB 345, stage IIA 27, stage IIB 163, stage IIIA 4, stage IIIB 113, stage IVA 32, stage IVB 26. The age ranged from 18 to 92 years with a mean of 49.9 years. Clinical characteristics included: nulliparity 11%, married 93%, obese 41%, hypertensive 37%, diabetes 10%, smoking 50%, bleeding 76%. The cumulative five-year survival for all patients was 67% and this was influenced by the stage of disease: stage IA 98%, stage IB 89%, stage IIA 72%, stage IIB 62%, stage III 37%, stage IVA 14%, stage IVB 4%. Patients with a well-differentiated tumor had an 85% survival rate while those with a poorly differentiated tumor had a 57% survival rate. The probability of metastatic disease to lymph nodes corresponded to the stage of disease; stage I 17%, stage II 55%, stage III 70%, stage IV 81%. When lymph nodes were negative, the survival rate for all patients was 86% while those with positive nodes had a 33% survival rate. Factors which influenced survival in the univariate analysis included stage, node status, tumor grade, age, interval from previous pelvic examination, diabetes. Only stage, node status and tumor grade maintained significance in the multiple proportion hazard analysis.