title: Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease.
abstract: BACKGROUND
  Pretreatment prognostic information is lacking for patients with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IB1 disease. Thus, we attempted to identify a high-risk subgroup among them prior to treatment.
  
  
  METHODS
  Cervical cancer FIGO stage IB1 patients who had received curative treatment with various modalities in our institute between January 2004 and December 2010 were enrolled. Pretreatment clinical parameters including age, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen, hemoglobin (Hb) level, platelet count, histological type, and treatment modality were analyzed for treatment outcomes.
  
  
  RESULTS
  One hundred ninety-seven patients were included with a median follow-up of 66 months (range 6-119 months). In Cox regression analysis, only SCC histology (HR 0.457, 95% CI 0.241-0.967, p = 0.017) was an independent factor predicting better disease-free survival (DFS). Among SCC histology, patients with an Hb level less than 12 g/dl and a SCC-Ag level more than 3 ng/ml had worse treatment outcomes. The 5-year DFS rates were 89.2, 69.3, and 44.4% for the patients at low-risk (SCC, Hb >12 g/dl, SCC-Ag ≤3 ng/ml), intermediate-risk (non-SCC), and high-risk (SCC, Hb ≤12 g/dl, SCC-Ag >3 ng/ml), respectively (p < 0.001).
  
  
  CONCLUSIONS
  Non-SCC and SCC histology with both anemia and high pretreatment SCC-Ag level were associated with recurrence. Further validation studies are warranted for clarification.
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Liu
authors.forename: Eng-Yen
authors.initials: EY
authors.lastname: Huang
authors.forename: Ching-Fen
authors.initials: CF
authors.lastname: Hu
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Ou
authors.forename: Chan-Chao
authors.initials: CC
authors.lastname: ChangChien
authors.forename: Chong-Jong
authors.initials: CJ
authors.lastname: Wang
authors.forename: Ching-Chou
authors.initials: CC
authors.lastname: Tsai
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Fu
authors.forename: Chen-Hsuan
authors.initials: CH
authors.lastname: Wu
authors.forename: Hao
authors.initials: H
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015843:Serpins / Q000032:analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000469:parasitology / Q000532:radiotherapy* / Q000601:surgery*
chemical_list: D000951:Antigens, Neoplasm; D015843:Serpins; C051072:squamous cell carcinoma-related antigen