title: Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy.
abstract: OBJECTIVE
  The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy.
  
  
  METHODS
  A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, lymphovascular space invasion, parametrial invasion, deep stromal invasion (>2/3 thickness), corpus invasion, vaginal infiltration, and ovarian metastasis, adjuvant therapy, and survival were collected and Cox regression analysis was used to determine independent prognostic factors.
  
  
  RESULTS
  An estimated five-year survival rate of stage IB1 was 96.6%, 75.0% in stage IB2, 100% in stage IIA, and 52.8% in stage IIB. Prognosis of patients with one positive-node site is similar to that of those with negative-node. Prognosis of patients with multiple positive-node sites was significantly poorer than that of negative and one positive-node site. Multivariate analysis revealed that lymph node metastasis, lymphovascular space invasion, and parametrial invasion were independent prognostic factors for cervical adenocarcinoma. Survival of patients with cervical adenocarcinoma was stratified into three groups by the combination of three independent prognostic factors.
  
  
  CONCLUSIONS
  Lymph node metastasis, lymphovascular space invasion, and parametrial invasion were shown to be independent prognostic factors for cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kato
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.forename: Mahito
authors.initials: M
authors.lastname: Takeda
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hosaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Mitamura
authors.forename: Noriko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Satoko
authors.initials: S
authors.lastname: Sudo
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Masataka
authors.initials: M
authors.lastname: Kudo
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
keywords: Adenocarcinoma; Cervical cancer; Multivariate analysis; Prognosis; Radical hysterectomy