Presurgical prognostic factors in carcinoma of the cervix, stages IB and IIA.
Possible prognostic factors in early stage cervical cancer include patient age, tumor size, cell type, differentiation, and channel invasion. In this study each of these factors was evaluated based only on the findings available before surgery, and the observations are compared with patient survival and incidence of node metastases. One hundred consecutive patients with stage IB or IIA cervical cancer treated by primary radical surgery and followed at least 2 years are reported. Disease-free survival was 90% at 2 years and 85% at 5 years; 19% had node metastases. Of the factors studied, only age greater than 50 years was associated with poor prognosis (p less than 0.02 versus age less than 50 years). Only large tumor size was associated with increased node metastases (p less than 0.001 versus medium and small size). Tumor cell type, differentiation, and channel involvement had no bearing on survival or node metastases. Because older age and large tumors appear to be factors of poor prognosis for surgery, and yet it is not clear that these patients fare better with radiotherapy, we suggest a prospective trial of radiotherapy versus surgery for this group.
O'Brien
D M
DM
Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada.
Carmichael
J A
JA
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology