title: Clinical tumor diameter and prognosis of patients with FIGO stage IB1 cervical cancer (JCOG0806-A).
abstract: OBJECTIVE
  In order to determine indications for less radical surgery such as modified radical hysterectomy, the risk of pathological parametrial involvement and prognosis of FIGO stage IB1 cervical cancer patients undergoing standard radical hysterectomy with pre-operatively assessed tumor diameter≤2 cm were investigated.
  
  
  METHODS
  We conducted a retrospective multi-institutional chart review of patients with FIGO stage IB1 cervical cancer who underwent primary surgical treatment between 1998 and 2002. The eligibility criteria for the analyses were (i) histologically-proven squamous cell carcinoma, adenocarcinoma or, adenosquamous cell carcinoma, (ii) radical hysterectomy performed, (iii) clinical tumor diameter data available by MR imaging or specimens by cone biopsy, and (iv) age between 20 and 70. Based on the clinical tumor diameter, patients were stratified into those with the following tumors: i) 2 cm or less (cT≤2 cm) and ii) greater than 2 cm (cT>2 cm). We expected 5-year OS of ≥95% and parametrial involvement<2-3% for patients with cT≤2 cm who underwent radical hysterectomy.
  
  
  RESULTS
  Of the 1269 patients enrolled, 604 were eligible for the planned analyses. Among these, 571 underwent radical hysterectomy (323 with cT≤2 cm and 248 with cT>2 cm). Parametrial involvement was present in 1.9% (6/323) with cT≤2 cm and 12.9% (32/248) with cT>2 cm. Five-year overall survivals were 95.8% (95% CI 92.9-97.6%) in cT≤2 cm and 91.9% (95% CI 87.6-94.8%) in cT>2 cm patients.
  
  
  CONCLUSIONS
  Patients with cT≤2 cm had lower risk of parametrial involvement and more favorable 5-year overall survival. They could therefore be good candidates for receiving less radical surgery.
authors: Department of Gynecologic Oncology, National Cancer Center Hospital, Japan. Electronic address: tokato@ncc.go.jp.
authors: Tomoyasu
authors: T
authors: Kato
authors: Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan.
authors: Atsuo
authors: A
authors: Takashima
authors: Department of Gynecologic Oncology, National Cancer Center Hospital, Japan.
authors: Takahiro
authors: T
authors: Kasamatsu
authors: Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan.
authors: Kenichi
authors: K
authors: Nakamura
authors: Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan.
authors: Junki
authors: J
authors: Mizusawa
authors: Department of Gynecologic Oncology, Aichi Cancer Center, Japan.
authors: Toru
authors: T
authors: Nakanishi
authors: Department of Gynecology, Cancer Institute Hospital, Japan.
authors: Nobuhiro
authors: N
authors: Takeshima
authors: Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
authors: Shoji
authors: S
authors: Kamiura
authors: Department of Obstetrics and Gynecology, Kitasato University, Japan.
authors: Takashi
authors: T
authors: Onda
authors: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Japan.
authors: Toshiyuki
authors: T
authors: Sumi
authors: Department of Obstetrics and Gynecology, National Defense Medical College, Japan.
authors: Masashi
authors: M
authors: Takano
authors: Department of Gynecology, Kinki University, Japan.
authors: Hidekatsu
authors: H
authors: Nakai
authors: Gynecologic Service, National Kyushu Cancer Center, Japan.
authors: Toshiaki
authors: T
authors: Saito
authors: Department of Gynecologic Oncology, Hyogo Cancer Center, Japan.
authors: Kiyoshi
authors: K
authors: Fujiwara
authors: Department of Gynecology and Obstetrics, Saga University, Japan.
authors: Masatoshi
authors: M
authors: Yokoyama
authors: Department of Obstetrics and Gynecology, Tottori University, Japan.
authors: Hiroaki
authors: H
authors: Itamochi
authors: Department of Gynecologic Oncology, Shikoku Cancer Center, Japan.
authors: Kazuhiro
authors: K
authors: Takehara
authors: Department of Gynecologic Oncology, Saitama Cancer Center, Japan.
authors: Harushige
authors: H
authors: Yokota
authors: Department of Gynecologic Oncology, Kure Medical Center, Japan.
authors: Tomoya
authors: T
authors: Mizunoe
authors: Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Japan.
authors: Satoru
authors: S
authors: Takeda
authors: Department of Obstetrics and Gynecology, Kyushu University, Japan.
authors: Kenzo
authors: K
authors: Sonoda
authors: Department of Obstetrics and Gynecology, Shinshu University, Japan.
authors: Tanri
authors: T
authors: Shiozawa
authors: Department of Obstetrics and Gynecology, Kagoshima City Hospital, Japan.
authors: Takayo
authors: T
authors: Kawabata
authors: Department of Gynecology, Niigata Cancer Center Hospital, Japan.
authors: Shigeru
authors: S
authors: Honma
authors: Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan.
authors: Haruhiko
authors: H
authors: Fukuda
authors: Department of Obstetrics and Gynecology, Tohoku University, Japan.
authors: Nobuo
authors: N
authors: Yaegashi
authors: Department of Obstetrics and Gynecology, University of Tsukuba, Japan.
authors: Hiroyuki
authors: H
authors: Yoshikawa
authors: Department of Gynecology and Obstetrics, Kyoto University, Japan.
authors: Ikuo
authors: I
authors: Konishi
authors: Department of Obstetrics and Gynecology, Kurume University, Japan.
authors: Toshiharu
authors: T
authors: Kamura
mesh_terms: D000328:Adult; D000368:Aged; D019092:Conization; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Cervical cancer; FIGO stage IB1; MR imaging; Radical hysterectomy; Tumor diameter