Histopathological prognostic factors in patients with cervical cancer treated with radical hysterectomy and postoperative radiotherapy.
BACKGROUND
Many studies have been performed, on the clinical outcome and prognostic factors in patients with cervical cancer treated with radical hysterectomy and postoperative radiotherapy, but no useful method for predicting the risk of recurrence has been established. The purpose of this study was to analyze histopathological prognostic factors. In addition, we proposed a new risk classification and evaluated its usefulness.


METHODS
One hundred and thirty patients with stage I-II uterine cervical cancer were treated with radical hysterectomy and postoperative radiotherapy at Ehime University Hospital between 1978 and 1997. All surgical specimens were reviewed, and the relationship between histopathological factors and the clinical outcome was analyzed.


RESULTS
Of the histopathological prognostic factors of the surgical specimens analyzed, six factors (parametrial invasion, venous infiltration, pelvic lymph node metastases, thickness of the residual muscular layer, tumor depth, and tumor growth pattern) were significant prognostic factors. In particular, venous infiltration and pelvic lymph node metastases were strongly correlated with recurrence. Using the above five factors (excluding the thickness of the residual muscle layer), all patients were scored based on the total number of poor prognostic factors, and were classified into three groups. Patients with a score of 0-1 were classified as the low-risk group, those with a score of 2 as the intermediate group, and those with a score of 3-5 as the high-risk group. The 5-year disease-free survival rates were 93% in the low-risk group, 82% in the intermediate group, and 56% in the high-risk group (P < 0.05).


CONCLUSIONS
Six prognostic factors were found. Our risk classification seems to be clinically useful to predict which patients are at risk of recurrence.
Shinohara
Syuichi
S
Department of Radiology, Ehime University School of Medicine, Shitsukawa, Shigenobu-cho, Ehime, 791-0295, Japan. sshinoha@m.ehime-u.ac.jp
Ochi
Takashi
T
Miyazaki
Tatsuhiko
T
Fujii
Takashi
T
Kawamura
Masashi
M
Mochizuki
Teruhito
T
Ito
Masaharu
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*