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The baseline recurrence risk of patients with intermediate-risk cervical cancer

Obstetrics & Gynecology Science 2021년 64권 2호 p.226 ~ 233
Yoneoka Yutaka, Kato Mayumi Kobayashi, Tanase Yasuhito, Uno Masaya, Ishikawa Mitsuya, Murakami Takashi, Kato Tomoyasu,
소속 상세정보
 ( Yoneoka Yutaka ) - National Cancer Center Hospital Department of Gynecology
 ( Kato Mayumi Kobayashi ) - National Cancer Center Hospital Department of Gynecology
 ( Tanase Yasuhito ) - National Cancer Center Hospital Department of Gynecology
 ( Uno Masaya ) - National Cancer Center Hospital Department of Gynecology
 ( Ishikawa Mitsuya ) - National Cancer Center Hospital Department of Gynecology
 ( Murakami Takashi ) - Shiga University of Medical Science Department of Obstetrics and Gynecology
 ( Kato Tomoyasu ) - National Cancer Center Hospital Department of Gynecology

Abstract


Objective: This study aimed to investigate the prognosis of patients with intermediate-risk cervical cancer and to evaluate the necessity of adjuvant therapy.

Methods: We conducted a retrospective chart review of patients with stage IB-II cervical cancer who underwent type III radical hysterectomy with pelvic lymphadenectomy between 2008 and 2017. In our institution, radical hysterectomy is performed as an open surgery and not as a minimally invasive surgery, and adjuvant therapy is not administered to patients with intermediate-risk cervical cancer. The intermediate-risk group included patients with 2 or more of the following factors: tumor size >4 cm, stromal invasion >1/2, and lymphovascular stromal invasion. Intermediate-risk patients with squamous cell carcinoma were included in the I-SCC group, whereas those with endocervical adenocarcinoma, usual type, or adenosquamous carcinoma were included in the I-Adeno group.

Results: There were 34 and 18 patients in the I-SCC and I-Adeno groups, respectively. The 5-year recurrence-free survival (RFS) and overall survival rates in the I-SCC group were 90.5% (95% confidence interval [CI], 85.3-95.7%) and 100% (95% CI, 100%), respectively, whereas those in the I-Adeno group were 54.9% (95% CI, 42.0-67.9%) and 76.1% (95% CI, 63.7-88.4%), respectively. Multivariate analysis revealed that endocervical adenocarcinoma, usual type, or adenosquamous carcinoma, and tumor size >4 cm had worse RFS.

Conclusion: The I-SCC group had good prognosis without adjuvant therapy; therefore, adjuvant therapy may be omitted in these patients. In contrast, the I-Adeno group had poor prognosis without adjuvant therapy; therefore, adjuvant therapy should be considered in their treatment.

키워드

Uterine cervical neoplasms; Recurrence; Carcinoma; Squamous cells; Adenocarcinoma

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