title: Intermediate-risk grouping of cervical cancer patients treated with radical hysterectomy: a Korean Gynecologic Oncology Group study.
abstract: BACKGROUND
  In this study, we sought to identify a criterion for the intermediate-risk grouping of patients with cervical cancer who exhibit any intermediate-risk factor after radical hysterectomy.
  
  
  METHODS
  In total, 2158 patients with pathologically proven stage IB-IIA cervical cancer with any intermediate-risk factor after radical hysterectomy were randomly assigned to two groups, a development group and a validation group, at a ratio of 3 : 1 (1620 patients:538 patients). To predict recurrence, multivariate models were developed using the development group. The ability of the models to discriminate between groups was validated using the log-rank test and receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  Four factors (histology, tumour size, deep stromal invasion (DSI), and lymphovascular space involvement (LVSI)) were significantly associated with disease recurrence and included in the models. Among the nine possible combinations of the four variables, models consisting of any two of the four intermediate-risk factors (tumour size ≥3 cm, DSI of the outer third of the cervix, LVSI, and adenocarcinoma or adenosquamous carcinoma histology) demonstrated the best performance for predicting recurrence.
  
  
  CONCLUSIONS
  This study identified a 'four-factor model' in which the presence of any two factors may be useful for predicting recurrence in patients with cervical cancer treated with radical hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Biometric Research Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 410-769, Korea.
authors.forename: B H
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 156-707, Korea.
authors.forename: T S
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Inha University School of Medicine, 7-206 Sinheung-dong, Jung-gu, Incheon 400-711, Korea.
authors.forename: E S
authors.initials: ES
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea.
authors.forename: C Y
authors.initials: CY
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seoungnam 463-707, Korea.
authors.forename: Y B
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon 443-721, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Ryu
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Gaegum-dong 633-165, Busanjin-gu, Busan 614-735, Korea.
authors.forename: K T
authors.initials: KT
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Dongsan Medical Center, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Korea.
authors.forename: C
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea.
authors.forename: S M
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul 135-710, Korea.
authors.forename: B G
authors.initials: BG
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul 135-710, Korea.
authors.forename: D S
authors.initials: DS
authors.lastname: Bae
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-Gil, Songpa-gu, Seoul 138-736, Korea.
authors.forename: Y T
authors.initials: YT
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-Gil, Songpa-gu, Seoul 138-736, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D056910:Republic of Korea; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult