Clinicopathologic factors for central recurrence in patients with locally advanced bulky cervical cancer.
OBJECTIVE
Locally advanced bulky cervical cancer (LABCC) is characterized by poor local control. The objective of this study was to identify the clinicopathologic variables associated with one-year central-only recurrence, which will serve as criteria for adjuvant hysterectomy after radiation (AHR) in patients with LABCC.


METHODS
Between January 2000 and August 2007, we retrospectively evaluated outcomes in 225 patients with LABCC who were initially treated with radiation or chemoradiation.


RESULTS
Among the 225 patients with LABCC, there were 41 recurrences within one year after treatment (8 central-only and 33 pelvis and/or distant site recurrences). Age, stage, and treatment type were not associated with the one-year central-only recurrences, but tumor size ≥8cm had a statistically significant association based on multivariate analysis (OR, 5.39; 95% CI, 1.15-25.31; p=0.03). The combination of non-squamous cell (non-SCC) type and tumor size ≥8cm had a significantly higher rate of recurrence within one year (OR, 43.0; 95% CI, 4.78-386.68; p<0.01).


CONCLUSIONS
Of patients with LABCC, those with non-SCC tumors ≥8cm in size were at high risk for early central-only recurrence after cisplatin-based chemoradiation, and represent the subset of patients for whom AHR is beneficial.
Department of Obstetrics & Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 215-4 Gongneung-dong, Nowon-gu, Seoul, Republic of Korea.
Won-Moo
WM
Lee
Sang-Il
SI
Park
Beob-Jong
BJ
Kim
Moon-Hong
MH
Kim
Seok-Cheol
SC
Choi
Eui-Don
ED
Lee
Sang-Young
SY
Ryu
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin