Abstract
Objective: This study was conducted to evaluate the surgical outcomes of patients with early-stage cervical cancer and to identify clinicopathological factors that may predict a 5-year disease-free survival of patients who are treated with modified or radical hysterectomies and pelvic lymphadenectomy.Methods: The record of 146 patients with early-stage invasive cervical carcinoma who had been treated at the HRH Princess Maha Chakri Sirindhorn Medical Center, in the period between January 2003 and December 2014 were retrospectively reviewed. Clinical and pathological variables that include age, wait time to surgery, stage of cancer, pelvic nodule status, lymphovascular space invasion, histology, depth of invasion, tumor grade, surgical margin status, parametrium involvement, and tumor size were recorded. The Kaplan-Meier statistical method was used for the calculation for the 5-year disease-free survival and the 5-year overall survival. The Log-rank test and Cox regression analysis were used to assess the significant factors relating to recurrence.Result: A Large population in this study was in Stage IB1 (62%). The most common histology obtained was of squamous cell carcinoma (68%). Approximately 77% of the patients underwent either a modified or radical hysterectomy and 25% had received adjuvant treatment. The median time of patient follows up was 60 months. The estimated 5-year disease-free survival of the patients with early-stage cervical cancer was 84%. Recurrent disease occurred in 14% of the patients and the majority of these (71%) were localized metastases. Stage, nodular status and tumor size were significant as poor prognostic factors resulting from the univariate analysis study. However, there were no statistically significant associations between these factors and the 5-year DFS on multivariable analysis. Conclusion: Early stage cervical cancer patients treated at our institute had favorable outcomes. The significant prognostic factors for disease-free survival were the stage, nodular status, and tumor size.
Highlights
Cervical cancer is the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases diagnosed in 2012 [1]
The mean age of the patients was 45 years with the majority of patients in the age group of 40-49 years which correlates with the ages for HPV-associated cervical cancer [2]
The general characteristics are consistent with many studies that had been done in other regions of Thailand [2,3,4,5]
Summary
We prefer radical surgery over primary radiation. Surgery has the advantages of providing a more accurate evaluation of the extent of the disease, preserves the ovarian function, takes less treatment course time and provides an easier method to correct complications. The focus of this article is the patients with cervical cancer stages Ia to IIa, treated by primary surgery at the HRH Princess Maha Chakri Sirindhorm Medical Center. We have reported on our long experience over the past 12 years (2003-2014). This study was conducted to evaluate the effectiveness of surgical treatment in women with early-stage cervical cancer and to determine the factors affecting a disease-free survival and the recurrent rates of patients with early-stage cervical cancer who had been treated at our institution over a period of 12 years
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