<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_abm-2019-0036_s_004_w2aab2b8c10b1b7b1aab1c14b1Aa"><h3>Background</h3><p>Survival for patients with early stage cervical cancer without any high-risk factors treated with radical hysterectomy is excellent. However, there are few data on the survival outcomes for low-risk and intermediate-risk early stage cervical cancer patients.</p></sec><sec id="j_abm-2019-0036_s_005_w2aab2b8c10b1b7b1aab1c14b2Aa"><h3>Objective</h3><p>To determine survival outcomes and prognostic factors of low-risk and intermediate-risk stage IB1 cervical cancer patients.</p></sec><sec id="j_abm-2019-0036_s_006_w2aab2b8c10b1b7b1aab1c14b3Aa"><h3>Methods</h3><p>Stage IB1 cervical cancer patients with radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. Patients with positive pelvic nodes, parametrial involvement, and positive margin who are classified as high-risk patients were excluded. Patients with squamous cell carcinoma or grade 1–2 adenocarcinoma, tumor size less than 2 cm, no lymphovascular space invasion (LVSI), and depth of stromal invasion (DSI) less than 10 mm were defined as low-risk patients. Survival was evaluated using the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed using Cox proportional-hazards regression.</p></sec><sec id="j_abm-2019-0036_s_007_w2aab2b8c10b1b7b1aab1c14b4Aa"><h3>Results</h3><p>There were 82 (42.3%) low-risk patients and 112 (57.7%) intermediate-risk patients. More patients in intermediate risk received adjuvant treatment (3.6% and 14.3%, <italic>P</italic> = 0.07). Three (3.6%) low-risk patients and 18 (16.1%) intermediate-risk patients had recurrent disease (<italic>P</italic> = 0.004). At median follow-up of 86 months, 1.2% of low-risk patients and 8.9% of intermediate-risk had cancer-related deaths (<italic>P</italic> = 0.02). Low-risk patients had significantly better 5-year disease-free survival (98.2% vs 91.1%, <italic>P</italic> = 0.01) and estimated 5-year overall survival (98.5% vs 91.1%, <italic>P</italic> = 0.01). DSI more than 10 mm and presence of LVSI were significantly associated with recurrence. However, LVSI was an independent prognostic factor.</p></sec><sec id="j_abm-2019-0036_s_008_w2aab2b8c10b1b7b1aab1c14b5Aa"><h3>Conclusion</h3><p>Stage IB1 cervical cancer patients had excellent survival. Low-risk patients had significantly better survival. Presence of LVSI was an independent prognostic factor.</p></sec></abstract>

BackgroundSurvival for patients with early stage cervical cancer without any high-risk factors treated with radical hysterectomy is excellent. However, there are few data on the survival outcomes for low-risk and intermediate-risk early stage cervical cancer patients.ObjectiveTo determine survival outcomes and prognostic factors of low-risk and intermediate-risk stage IB1 cervical cancer patients.MethodsStage IB1 cervical cancer patients with radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. Patients with positive pelvic nodes, parametrial involvement, and positive margin who are classified as high-risk patients were excluded. Patients with squamous cell carcinoma or grade 1–2 adenocarcinoma, tumor size less than 2 cm, no lymphovascular space invasion (LVSI), and depth of stromal invasion (DSI) less than 10 mm were defined as low-risk patients. Survival was evaluated using the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed using Cox proportional-hazards regression.ResultsThere were 82 (42.3%) low-risk patients and 112 (57.7%) intermediate-risk patients. More patients in intermediate risk received adjuvant treatment (3.6% and 14.3%, P = 0.07). Three (3.6%) low-risk patients and 18 (16.1%) intermediate-risk patients had recurrent disease (P = 0.004). At median follow-up of 86 months, 1.2% of low-risk patients and 8.9% of intermediate-risk had cancer-related deaths (P = 0.02). Low-risk patients had significantly better 5-year disease-free survival (98.2% vs 91.1%, P = 0.01) and estimated 5-year overall survival (98.5% vs 91.1%, P = 0.01). DSI more than 10 mm and presence of LVSI were significantly associated with recurrence. However, LVSI was an independent prognostic factor.ConclusionStage IB1 cervical cancer patients had excellent survival. Low-risk patients had significantly better survival. Presence of LVSI was an independent prognostic factor.

Survival outcomes of low-risk and intermediate-risk stage IB1 cervical cancer patients

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

BackgroundSurvival for patients with early stage cervical cancer without any high-risk factors treated with radical hysterectomy is excellent. However, there...

Variables	5-year DFS (%)	P	95% CI
Histology		0.79	0.35–2.33
Squamous cell carcinoma	92.7
Adenocarcinoma	98.2
Adenosquamous carcinoma	83.4
Depth of stromal invasion		0.04	1.02–9.00
10 millimeters or less	95.2
More than 10 millimeters	91.1
Stromal invasion (%)		0.27	0.60–5.66
<50%	94.9
>50%	93.6
Tumor size		0.12	0.75–7.97
2 centimeters or less	94.1
More than 2 centimeters	96.6
Lymphovascular space invasion		0.003	1.59–32.32
Negative	97.4
Positive	90
Adjuvant therapy		0.23	0.44–3.87
No	94.6
Yes	99.8

	Low-risk patients (n = 79)	Intermediate-risk patients (n = 96)	P P < 0.05 was considered as statistically significant.
Recurrent disease	3 (3.8%)	13 (13.5%)	0.005
Vaginal cuff	2 (2.5%)	5 (5.2%)
Pelvis	1 (1.2%)	4 (4.2%)
Distant	0 (0%)	1 (1%)
Local and distant	0 (0%)	3 (3.1%)
Cancer-related deaths	1 (1.2%)	8 (8.3%)	0.03

Survival outcomes of low-risk and intermediate-risk stage IB1 cervical cancer patients

Article Category: Brief communication (original)

Published Online: Dec 19, 2019

Page range: 27 - 32

DOI: https://doi.org/10.1515/abm-2019-0036

Keywords
prognostic, survival, uterine cervical neoplasms

© 2019 Asama Vanichtantikul et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2

Prognostic variables associated with a 5-year DFS

Outcomes of patients without adjuvant treatment

Survival outcomes of low-risk and intermediate-risk stage IB1 cervical cancer patients

Article Category: Brief communication (original)

Published Online: Dec 19, 2019

Page range: 27 - 32

DOI: https://doi.org/10.1515/abm-2019-0036

Keywordsprognostic, survival, uterine cervical neoplasms

© 2019 Asama Vanichtantikul et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2

Prognostic variables associated with a 5-year DFS

Outcomes of patients without adjuvant treatment

Keywords
prognostic, survival, uterine cervical neoplasms