- Volume 15 Issue 5
DOI QR Code
Predicting Factors for Positive Vaginal Surgical Margin Following Radical Hysterectomy for Stage IB1 Carcinoma of the Cervix
- Sethasathien, Sethawat (Department of Obstetrics and Gynecology, Chiang Mai University) ;
- Charoenkwan, Kittipat (Department of Obstetrics and Gynecology, Chiang Mai University) ;
- Settakorn, Jongkolnee (Department of Pathology Faculty of Medicine, Chiang Mai University) ;
- Srisomboon, Jatupol (Department of Obstetrics and Gynecology, Chiang Mai University)
- Published : 2014.03.01
Background: To examine the incidence of positive vaginal surgical margins and determine the predicting factors following radical hysterectomy for stage IB1 carcinoma of the cervix. Materials and Methods: The clinical and histological data of 656 FIGO stage IB1 cervical cancer patients who had radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2012 were retrospectively reviewed and were analyzed for their association with a positive vaginal surgical margin. A p-value of < 0.05 was considered significant. Results: Thirty-five patients (5.3%) had positive vaginal surgical margins following RHPL; 24 (3.7%) for intraepithelial lesions and 11 (1.7%) for carcinoma. On multivariate analysis, microscopic vaginal involvement by high-grade squamous intraepithelial lesion and/or carcinoma (adjusted odd ratio (OR) 186.8; 95% confidence interval (CI) 48.5-718.5) and squamous histology (OR 8.7; 95% CI 1.7-44.0), were significantly associated with positive vaginal surgical margin. Conclusions: Microscopic vaginal involvement by HSIL and/or carcinoma are strong predictors for positive vaginal surgical margins for stage IB1 cervical cancer patients undergoing radical hysterectomy. Preoperative 'mapping' colposcopy or other strategies should be considered to ensure optimal vaginal resection.
- Landoni F, Maneo A, Colombo A, et al (1997). Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet, 350, 535-40. https://doi.org/10.1016/S0140-6736(97)02250-2
- Rudtanasudjatum K, Charoenkwan K, Khunamornpong S, Siriaunkgul S (2011). Impact of histology on prognosis of patients with early-stage cervical cancer treated with radical surgery. Int J Gynecol Obstet, 115, 183-7. https://doi.org/10.1016/j.ijgo.2011.06.011
- Delgado G, Bundy BN, Fowler WC, et al (1989). A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol, 35, 314-20. https://doi.org/10.1016/0090-8258(89)90070-X
- Estape RE, Angioli R, Madrigal M, et al (1998). Close vaginal margins as a prognostic factor after radical hysterectomy. Gynecol Oncol, 68, 229-32. https://doi.org/10.1006/gyno.1998.4960
- Kasamatsu T, Onda T, Sawada M, et al (2009). Radical hysterectomy for FIGO stage I-IIB adenocarcinoma of the uterine cervix. Br J Cancer, 100, 1400-5. https://doi.org/10.1038/sj.bjc.6605048
- Kim K, Cho SY, Park SI, et al (2011). Vaginal and pelvic recurrence rates based on vaginal cuff length in patients with cervical cancer who underwent radical hysterectomies. Eur J Surg Oncol, 37, 824-7. https://doi.org/10.1016/j.ejso.2011.06.010
- Look KY, Brunetto VL, Clarke-Pearson DL, et al (1996). An analysis of cell type in patients with surgically staged stage IB carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol, 63, 304-11. https://doi.org/10.1006/gyno.1996.0327
- McCann GA, Taege SK, Boutsicaris CE, et al (2013). The impact of close surgical margins after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol, 128, 44-8. https://doi.org/10.1016/j.ygyno.2012.10.028
- Nakanishi T, Ishikawa H, Suzuki Y, et al (2000). A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol, 79, 289-93. https://doi.org/10.1006/gyno.2000.5935
- Randall ME, Fracasso PM, Toita T, et al (2013). Principles and practice of gynecologic oncology. Sixth ed. Philadelphia: Lippincott Williams & Wilkins, 598-660.
- Chittithaworn S, Hanprasertpong J, Tungsinmunkong K, Geater A (2007). Association between prognostic factors and disease-free survival of cervical cancer stage IB1 patients undergoing radical hysterectomy. Asian Pac J Cancer Prev, 8, 530-4.
- An Audit of 204 Histopathology Reports Over Three Years of Carcinoma of Cervix: Experience from a Tertiary Referral Centre vol.16, pp.14, 2015, https://doi.org/10.7314/APJCP.2015.16.14.5643