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Pathologic Risk Factors and Oncologic Outcomes in Early-stage Cervical Cancer Patients Treated by Radical Hysterectomy and Pelvic Lymphadenectomy at a Thai University Hospital: A 7 year Retrospective Review

  • Ruengkhachorn, Irene (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Therasakvichya, Suwanit (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Warnnissorn, Malee (Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Leelaphatanadit, Chairat (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Sangkarat, Suthi (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Srisombat, Jutatip (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University)
  • Published : 2015.09.02

Abstract

Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.

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