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

Year 2023, , 1840 - 1845, 01.10.2023
https://doi.org/10.38136/jgon.1281206

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.

References

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjo- mataram I, Jemal A, et al. Global cancer statistics 2020: GLO- BOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021;71(3):209-49. 2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estima- tes of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394- 424. 3. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. International journal of gynecology & obstetrics. 2018;143:22-36.

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

Year 2023, , 1840 - 1845, 01.10.2023
https://doi.org/10.38136/jgon.1281206

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.

References

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjo- mataram I, Jemal A, et al. Global cancer statistics 2020: GLO- BOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021;71(3):209-49. 2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estima- tes of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394- 424. 3. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. International journal of gynecology & obstetrics. 2018;143:22-36.
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Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Abdurrahman Alp Tokalıoglu 0000-0002-1776-2744

Fatih Çelik 0000-0002-9523-180X

Burak Ersak 0000-0003-3301-062X

Okan Aytekin 0000-0002-6430-4607

İlker Selcuk 0000-0003-0499-5722

İzzet Özgürlük 0000-0002-9553-9265

Özlem Moraloğlu Tekin 0000-0001-8167-3837

Bülent Özdal 0000-0001-9829-688X

Publication Date October 1, 2023
Submission Date April 11, 2023
Acceptance Date June 1, 2023
Published in Issue Year 2023

Cite

Vancouver Tokalıoglu AA, Çelik F, Ersak B, Aytekin O, Selcuk İ, Özgürlük İ, Moraloğlu Tekin Ö, Özdal B. Predicting Factors of Uterine Invasion in Early-Stage (FIGO 2014 Stage IB1–IIA2) Cervical Cancer. JGON. 2023;20(3):1840-5.