The prognostic factors in cervical carcinoma treated by radical hysterectomy combined with pelvic radiotherapy.

Abstract

e15584 Background: Local regional lymp node is the main recurrence site in cervical carcinoma after radical hysterectomy. A retrospective analysis is used to evaluate the efficacy of pelvic radiotherapy and prognostic factors for stage IB-IIB (FIGO Stage) cervical carcinoma initially treated by surgery. Methods: From May 1998 to Dec 2006, a total of 77 patients of cervical carcinoma staged IB-IIB patients were eligible for this retrospective analysis. The diseases were staged IB in 20, IIA in 27 and IIB in 30 patients. All of them received external beam irradiation with 6MV X-ray 50Gy/25 fractions to pelvic field after radical hysterectomy. Overall survival rate was estimated by using Kaplan-Meier method. The prognostic factors were analyzed using univariate (Log rank) and multivariate Cox model. Results: The follow-up time was 5-152 months (median 33 months). The overall 5-year survival rate of stage IB, IIA and IIB were 79.4%, 69.8% and 51.9%, respectively. On univariate analysis, variables significantly associated with positive included age≤35 years (χ2=4.569, P=0.033), anaemia (χ2=4.806, P=0.028), stage≥IIB (χ2=6.120, P=0.013), tumor diameter ≥ 4cm (χ2=8.238, P=0.004)and pelvic lymph node metastasis (χ2=5.582, P=0.018). However in the multivariate analysis, only age ≤ 35 years (χ2=5.637, P=0.018), tumor diameter ≥ 4 cm (χ2=4.377, P=0.036) and pelvic lymph node metastasis (χ2=7.814, P=0.005) were significant factors associated with poorer prognosis. Conclusions: Postoperative adjuvant pelvic radiotherapy can improve the efficacy of patients for stage IB-IIB cervical carcinoma. Age ≤ 35 years, tumor diameter ≥ 4 cm and pelvic lymph node metastasis were confirmed as the independent prognostic factors.