Long term outcomes of patients who underwent radical hsyterectomy for cervical cancer

Year 2022, , 239 - 246, 17.01.2022

Ahmet Bilgi , Mete Can Ateş , Havva Hande Keser Şahin , Fazıl Avcı , Mehmet Kulhan , Abdül Hamid Güler , Ersin Çintesun , Cetin Celik

https://doi.org/10.32322/jhsm.1018961

Abstract

Introduction: We aimed to examine the parameters affecting long-term prognosis and survival in patients diagnosed with early stage cervical cancer and undergoing radical hysterectomy in our Gynecology and Obstetrics Clinic.
Material and Method: The files of 86 cervical cancer patients who underwent radical hysterectomy and pelvic paraaortic lymph node dissection for cervical cancer between 2010 and 2021 were retrospectively reviewed. Tumor size, FIGO stage, vagina, endometrium, ovary, parametrium, pelvic lymph node, paraaortic lymph node and deep stromal involvement were examined by examining the files and pathology reports of the patients. Then, the effects of these parameters on pelvic and paraaortic lymph node involvement, postoperative prognosis and survival of the patients were tried to be revealed.
Results: The 86 patients included in the analysis had a mean age of 55.2 (range: 38-72) and a median tumor size of 35 mm (range: 2-74). Cell type was squamous cell carcinoma in 81.4% and adenocarcinoma in 18.6% of the patient group. During the follow-ups, recurrence was detected in 22 (25.6%) patients. During the follow-up period, it was found that 18 (20.9%) patients died. In univariate analysis, the presence of metastases in any lymph node was found to reduce DFS and OS. The mean follow-up period of the cases examined was 66 (min:12-max:132) months; The mean OS and DFS of the patients were 111.84 (95% CI:103.26-120.43) and 105.72 (95% CI:95.87-115.57) months, respectively.
Conclusion: Pelvic and paraaortic lymph node involvement was found to be the most important prognostic factor regardless of histological type in cervical cancers. Survival was found to be significantly lower in patients with any lymph node involvement.

Keywords

Cervical cancer, radiotherapy, radical hysterectomy, prognostic factor, survival

References

• Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424.
• Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65: 87-108.
• Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009; 105: 103-4.
• Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet 2018; 143: 22-36.
• Falcetta FS, Medeiros LR, Edelweiss MI, Pohlmann PR, Stein AT, Rosa DD. Adjuvant platinum-based chemotherapy for early stage cervical cancer. Cochrane Database Syst Rev 2016; 11: Cd005342.
• Howlader N, Noone A, Krapcho M, et al. SEER cancer statistics review, 1975-2014, National Cancer Institute. Bethesda, MD 2017: 1-12.
• Hsu HC, Li X, Curtin JP, Goldberg JD, Schiff PB. Surveillance epidemiology and end results analysis demonstrates improvement in overall survival for cervical cancer patients treated in the era of concurrent chemoradiotherapy. Front Oncol 2015; 5: 81.
• Shu P, Li R, Xie D, He Y, Wang X, Li Q. Clinical profile and treatment outcome of collision carcinoma in cervix. Medicine 2020; 99: e19131.
• Wu J, Logue T, Kaplan SJ, Melamed A, et al. Less radical surgery for early-stage cervical cancer: a systematic review. Am J Obstet Gynecol 2021; 224: 348-58.e5.
• Quinn MA, Benedet JL, Odicino F, et al. Carcinoma of the Cervix Uteri. Int J Gynaecol Obstet 2006; 95: S43-s103.
• Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol 1990; 38: 352-7.
• Uno T, Ito H, Isobe K, et al. Postoperative pelvic radiotherapy for cervical cancer patients with positive parametrial invasion. Gynecol Oncol 2005; 96: 335-40.
• He D, Duan C, Chen J, Lai L, Chen J, Chen D. The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer: a systematic review and meta analysis. Int J Clin Exp Med 2015; 8: 14693-700.
• Monaghan JM, Ireland D, Mor-Yosef S, Pearson SE, Lopes A, Sinha DP. Role of centralization of surgery in Stage IB carcinoma of the cervix: a review of 498 cases. Gynecol Oncol 1990; 37: 206-9.
• Kim SM, Choi HS, Byun JS. Overall 5-year survival rate and prognostic factors in patients with stage IB and IIA cervical cancer treated by radical hysterectomy and pelvic lymph node dissection. Int J Gynecol Cancer 2000; 10: 305-12.
• Shinohara S, Ochi T, Miyazaki T, et al. Histopathological prognostic factors in patients with cervical cancer treated with radical hysterectomy and postoperative radiotherapy. Int J Clin Oncol 2004; 9: 503-9.
• Burghardt E, Baltzer J, Tulusan AH, Haas J. Results of surgical treatment of 1028 cervical cancers studied with volumetry. Cancer 1992; 70: 648-55.
• Galic V, Herzog TJ, Lewin SN, et al. Prognostic significance of adenocarcinoma histology in women with cervical cancer. Gynecol Oncol 2012; 125: 287-91.
• Nakanishi T, Ishikawa H, Suzuki Y, Inoue T, Nakamura S, Kuzuya K. A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol 2000; 79: 289-93.