Isolated full-thickness cervical stromal invasion warrants post-hysterectomy pelvic radiotherapy in FIGO stages IB-IIA uterine cervical carcinoma

Sung Ho Moon, Hong Gyun Wu, Sung W. Ha, Hyo Pyo Lee, Soon Beom Kang, Yong Sang Song, Noh Hyun Park, Jae Won Kim, In Ae Park, Baek hui kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To evaluate the potential benefit of postoperative radiotherapy (PORT) in women with isolated full-thickness cervical stromal invasion (FTSI) as an unfavorable pathological finding after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stages IB-IIA cervical carcinoma. Methods: A total of 1868 patients with stages IB-IIA cervical carcinoma underwent radical hysterectomy and PLND between January 1982 and December 2002. Seventy-four of these patients had isolated FTSI without any other unfavorable pathological finding, such as lymph node metastasis, microscopic parametrial involvement, involved resection margin, lympho-vascular space invasion, or large clinical tumor diameter (> 4 cm). Forty-one of these patients had no adjuvant treatment (S group) and 33 received PORT (PORT group). Patients with isolated FTSI who received chemotherapy were excluded. Treatment outcomes in the PORT and S groups were compared. Results: Ten-year disease-free survival (DFS) and pelvic-failure-free survival (PFFS) of S group vs. PORT group were 73.2% vs. 92.4% (P = 0.038) and 79.8% vs. 97.0% (P = 0.044), respectively. According to a Cox proportional hazards model developed by forward, stepwise regression incorporating all prognostic variables, only PORT was marginally significant for DFS (RR 0.234; 95% CI 0.051-1.067; P = 0.061) and significant for PFFS (RR 0.055; 95% CI 0.005-0.620; P = 0.019). A grade 4 late complication developed in two patients (6%) in PORT group. Conclusion: PORT administered to patients with isolated FTSI after radical hysterectomy and PLND improves pelvic control in FIGO stages IB-IIA cervical carcinoma with acceptable morbidity.

Original languageEnglish
Pages (from-to)152-157
Number of pages6
JournalGynecologic Oncology
Volume104
Issue number1
DOIs
Publication statusPublished - 2007 Jan

Keywords

  • Cervical cancer
  • Depth of invasion
  • Hysterectomy
  • Prognosis
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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