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. 2013 Jul;24(3):222-8.
doi: 10.3802/jgo.2013.24.3.222. Epub 2013 Jul 4.

Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy

Tatsuya Kato  1 , Hidemichi Watari, Mahito Takeda, Masayoshi Hosaka, Takashi Mitamura, Noriko Kobayashi, Satoko Sudo, Masanori Kaneuchi, Masataka Kudo, Noriaki Sakuragi
Affiliations

Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy

Tatsuya Kato et al. J Gynecol Oncol. 2013 Jul.

Abstract

Objective: The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy.

Methods: A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, lymphovascular space invasion, parametrial invasion, deep stromal invasion (>2/3 thickness), corpus invasion, vaginal infiltration, and ovarian metastasis, adjuvant therapy, and survival were collected and Cox regression analysis was used to determine independent prognostic factors.

Results: An estimated five-year survival rate of stage IB1 was 96.6%, 75.0% in stage IB2, 100% in stage IIA, and 52.8% in stage IIB. Prognosis of patients with one positive-node site is similar to that of those with negative-node. Prognosis of patients with multiple positive-node sites was significantly poorer than that of negative and one positive-node site. Multivariate analysis revealed that lymph node metastasis, lymphovascular space invasion, and parametrial invasion were independent prognostic factors for cervical adenocarcinoma. Survival of patients with cervical adenocarcinoma was stratified into three groups by the combination of three independent prognostic factors.

Conclusion: Lymph node metastasis, lymphovascular space invasion, and parametrial invasion were shown to be independent prognostic factors for cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy.

Keywords: Adenocarcinoma; Cervical cancer; Multivariate analysis; Prognosis; Radical hysterectomy.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Survival of adenocarcinoma of the uterine cervix according to ovarian metastasis. All cases of ovarian metastasis had stage IIB disease. Ovarian metastasis was found in 12 of 130 cases (9%), and 11 of 12 cases died within five years.
Fig. 2
Fig. 2
Stratification of survival of the patients with cervical adenocarcinoma by the combination of three independent prognosticators. An estimated five-year survival rate for the patients without three independent risk factors was 98%, that for the patients with lymphovascular space invasion (LVSI) and/or parametrial invasion (PI) without lymph node metastasis (LNM) was 75%, and that for the patients with LNM irrespective of the presence of LVSI/PI was 37%.
Fig. 3
Fig. 3
Impact of lymph node metastasis (LNM) on the survival of adenocarcinoma of the uterine cervix. Estimated five-year survival rate of the patients without LNM (group A) was 89%, that with one positive-node site (group B), and that with more than two positive-node sites (group C) was 86% and 23%, respectively.
Fig. 4
Fig. 4
Comparison of overall survival according to the histologic type. ADC, adenocarcinoma; SCC, squamous cell carcinoma.
See this image and copyright information in PMC

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