Predicting Factors of Uterine Invasion in Early-Stage (FIGO 2014 Stage IB1–IIA2) Cervical Cancer

Abstract

Objective: Uterine corpus involvement was demonstrated radiologically or diagnosed by endometrial biopsy in the previous reports. Thus, there are few studies that detect uterine corpus involvement in radical hysterectomy specimens. This study was designed to investigate the factors that influence uterine corpus involvement in surgically treated cervical cancer patients. Materials and Methods: A total of 269 patients with clinical early-stage (stageIB1-IIA2) cervical cancer who underwent radical hysterectomy and pelvic-paraaortic lymphadenectomy at Zekai Tahir Burak Women's Health Training and Research Hospital and Ankara Bilkent City Hospital between January 2008 and August 2021 were recruited, and their clinicopathologic data were extracted from their patient files or the hospital's electronic database. Results: Uterine invasion was positive in 102 (37.9%) patients. Tumor size of patients was ≤20 mm in 66 (24.5%) patients and >40 mm in 82 (30.5%). Parametrial invasion was detected in 44 (16.4%) patients. In the multivariate analysis; tumor type (adenocancer vs. other tumor types) (HR: 8.94; 95% CI: 3.569–22.401; p<0.001), tumor size (>35 mm vs. ≤35 mm) (HR: 2.34; 95% CI: 1.234–4.440; p=0.009) depth of stromal invasion (>1/2 vs. ≤1/2) (HR: 6.63; 95% CI: 2.205–19.952; p<0.001), parametrial metastasis (positive vs. negative) (HR: 2.86; 95% CI: 1.220–6.707; p=0.016) were found to be independent predictor of uterine invasion. Conclusion: Tumor type, stromal invasion depth, and parametrial metastasis were independent risk factors for invasion of the uterine corpus. We believe that the presence of uterine invasion will play an important role in the treatment of cervical cancer, despite the fact that surgical-pathologic findings have not traditionally been used to determine cervical cancer staging.

Keywords

• Cervical cancer
• uterine invasion
• radical hysterectomy

References

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