title: Tumor size and lymph node status determined by imaging are reliable factors for predicting advanced cervical cancer prognosis.
abstract: The aim of the present study was to investigate the prognostic role of a number of clinical factors in advanced cervical cancer patients. Patients (n=157) with stage IIA-IIB cervical cancer treated at four Hallym Medical Centers in South Korea (Hallym University Sacred Heart Hospital; Kangnam Sacred Heart Hospital; Chuncheon Sacred Heart Hospital; and Kangdong Sacred Heart Hospital) between 2006 and 2010 were retrospectively enrolled. Univariate analysis identified significant predictive values in the following eight factors: i) Cancer stage (P<0.0001); ii) tumor size (≤4 vs. 4-6 cm, P=0.0147; and ≤4 vs. >6 cm, P<0.0001); iii) serum squamous cell carcinoma antigen level (≤2 vs. >15 ng/ml; P=0.0291); iv) lower third vaginal involvement (P<0.0001); v) hydronephrosis (P=0.0003); vi) bladder/rectum involvement (P=0.0015); vii) pelvic (P=0.0017) or para-aortic (P=0.0019) lymph node (LN) metastasis detected by imaging vs. no metastasis; and viii) pelvic LN metastasis identified by pathological analysis (P=0.0289). Furthermore, multivariate analysis determined that tumor size (≤4 vs. 4-6 cm, P=0.0371; and ≤4 vs. >6 cm, P=0.0024) and pelvic LN metastasis determined by imaging vs. no metastasis (P=0.0499) were independent predictive variables. Therefore, tumor size and pelvic LN metastasis measured by imaging were independent predictive factors for the prognosis of advanced cervical cancer. These factors may provide more clinically significant prognostic information compared with the currently used International Federation of Gynecology and Obstetrics staging system.
authors.affiliation: Department of Obstetrics and Gynecology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwasung, Gyeonggi 445-907, Republic of Korea.
authors.forename: Min Sun
authors.initials: MS
authors.lastname: Kyung
authors.affiliation: Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 150-950, Republic of Korea.
authors.forename: Hong Bae
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Gyeonggi 431-070, Republic of Korea.
authors.forename: Jung Yeob
authors.initials: JY
authors.lastname: Seoung
authors.affiliation: Department of Medicine, Hallym University College of Medicine, Chuncheon, Gangwon 200-702, Republic of Korea.
authors.forename: In Young
authors.initials: IY
authors.lastname: Choi
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Gyeonggi 431-070, Republic of Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Joo
authors.affiliation: Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Gyeonggi 431-070, Republic of Korea.
authors.forename: Me Yeon
authors.initials: MY
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwasung, Gyeonggi 445-907, Republic of Korea.
authors.forename: Jung Bae
authors.initials: JB
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Gyeonggi 431-070, Republic of Korea.
authors.forename: Young Han
authors.initials: YH
authors.lastname: Park
keywords: pelvic lymph node; prognosis; tumor size; uterine cervical cancer