title: Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery.
abstract: BACKGROUND
  The aim of this study was to determine risk factors associated with parametrial involvement (PI) and to identify the subgroup of patients at low risk for PI.
  
  
  METHODS
  The study comprised 565 patients with early-stage cervical cancer, who underwent radical hysterectomy with pelvic node dissection at Songklanagarind Hospital between 1987 and 2011. Analysis was performed to determine factors associated with PI.
  
  
  RESULTS
  Overall, 24 (4.25%) women had PI. PI was more common in patients with non-squamous cell carcinoma, deep stromal invasion (DSI), tumor size > 2 cm, lymphovascular space invasion (LVSI), and pelvic node involvement. Multivariate analysis showed that DSI (p < 0.001) and tumor size > 2 cm (p < 0.001) were independently associated with PI. PI was linked with decreased recurrence-free (p < 0.001) and overall (p = 0.002) survival. Of 347 patients with tumor size ≤ 2 cm and no DSI, only 1 (0.29%) had PI.
  
  
  CONCLUSIONS
  These findings confirm that PI in early-stage cervical cancer is uncommon. Risk factors associated with PI were DSI and tumor size > 2 cm. PI is a predictor of cervical cancer recurrence and decreased survival. Less radical surgery may be considered in low-risk patients.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Ingporn
authors.initials: I
authors.lastname: Jiamset
authors.forename: Jitti
authors.initials: J
authors.lastname: Hanprasertpong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality* / Q000706:statistics & numerical data; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018579:Patient Selection; D010537:Peritoneum / Q000473:pathology*; D011300:Preoperative Care; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult