Abstract
PurposeTo evaluate the impact of different adjuvant therapy on IB1 and IIA1 stage cervical squamous cell cancer patients with lymphovascular space invasion. It also aimed to analyze the relationship between lymphovascular space invasion and other clinical pathological characteristics on IB1 and IIA1 stage cervical squamous cell cancer patients.MethodsThis retrospective observational study collected data of FIGO stages IB1 and IIA1 squamous cervical cancer patients at the First Affiliated Hospital of Chongqing Medical University between 2014 and 2018. A correlation analysis between lymphovascular space invasion and other clinical or pathological factors was conducted. Prognosis analysis of patients with lymphovascular space invasion were performed to assess associations between clinical-pathological characteristics and survival.ResultsA total of 357 women were identified including 110 (30.8%) with lymphovascular space invasion, 247 (69.2%) without lymphovascular space invasion. Both middle 1/3 cervical stromal invasion (p = 0.000) and deep 1/3 cervical stromal invasion (p = 0.000) were independently associated with lymphovascular space invasion. Among lymphovascular space involved women, tumor differentiation (P = 0.001) and postoperative therapy (P = 0.036) had a significant influence on disease recurrence. Multivariate analysis showed that lymph node metastasis (P = 0.017), poorer tumor differentiation (P = 0.036) and postoperative chemotherapy alone (P = 0.021) can increase the risk of tumor relapse.ConclusionOur study suggested that the presence of deep stromal invasion independently increases the risk of lymphovascular space invasion. Compared with chemotherapy, chemoradiotherapy seems to improve progression-free survival in squamous cervical cancer patients with lymphovascular space invasion.
Highlights
Cervical cancer, being the fourth most frequent malignant tumor among women, is one of the leading causes of female death
The current study revealed that deep stromal invasion was the single independent risk factor of lymphovascular space invasion (LVSI)+
Univariate analysis indicated that poorer tumor differentiation and postoperative chemotherapy alone are associated with higher possibility of recurrence for LVSI+ early-stage invasive squamous cervical carcinoma
Summary
Cervical cancer, being the fourth most frequent malignant tumor among women, is one of the leading causes of female death. In 2020, it was estimated that there were 604,000 new cases of cervical cancer and 342,000 deaths worldwide [1]. 80% of all cervical cancer are squamous cell cancer, while. Zhang et al BMC Cancer (2022) 22:202 adenocarcinoma and other pathological type makes up the rest. With the popularization of the screening test, more and more patients are diagnosed with cervical cancer in an early stage. Surgery is the preferred modality for the treatment of early invasive cervical cancer (FIGO stage 2009 IB1, IIA1), which usually consists of a type C radical hysterectomy with pelvic lymphadenectomy [2]. Postoperative treatment is indicated for patients with adverse pathologic factors
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