Browse > Article
http://dx.doi.org/10.7314/APJCP.2014.15.2.887

Locoregional Spread and Survival of Stage IIA1 versus Stage IIA2 Cervical Cancer  

Hongladaromp, Waroonsiri (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
Tantipalakorn, Charuwan (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
Charoenkwan, Kittipat (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
Srisomboon, Jatupol (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.2, 2014 , pp. 887-890 More about this Journal
Abstract
This study was undertaken to compare surgical outcomes and survival rates of patients with the 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIA1 versus IIA2 cervical cancer treated with radical hysterectomy and pelvic lymphadenectomy (RHPL). Patients with stage IIA cervical cancer undergoing primary RHPL between January 2003 and December 2012 at Chiang Mai University Hospital were retrospectively reviewed. The analysis included clinicopathologic variables, i.e. nodal metastasis, parametrial involvement, positive surgical margins, deep stromal invasion (DSI)), lymph-vascular space invasion (LVSI), adjuvant treatment, and 5-year survival. The chi square test, Kaplan-Meier method and log-rank test were used for statistical analysis. During the study period, 133 women with stage IIA cervical cancer, 101 (75.9 %) stage IIA1, and 32 (24.1 %) stage IIA2 underwent RHPL. The clinicopathologic variables of stage IIA1 compared with stage IIA2 were as follows: nodal metastasis (38.6% vs 40.6%, p=0.84), parametrial involvement (10.9% vs 15.6%, p=0.47), positive surgical margins (31.7% vs 31.3%, p=1.0), DSI (39.6% vs 53.1%, p=0.18), LVSI (52.5% vs 71.9%, p=0.05) and adjuvant radiation (72.3% vs 84.4%, p=0.33). With a median follow-up of 60 months, the 5-year disease-free survival (84.6% vs 88.7%, p=0.67) and the 5-year overall survival (83.4% vs 90.0%, P=0.49) did not significantly differ between stage IIA1 and stage IIA2 cervical cancer. In conclusion, patients with stage IIA1 and stage IIA2 cervical cancer have comparable rates of locoregional spread and survival. The need for receiving adjuvant radiation was very high in both substages. The revised 2009 FIGO system did not demonstrate significant survival differences in stage IIA cervical cancer treated with radical hysterectomy. Concurrent chemoradiation should be considered a more suitable treatment for patients with stage IIA cervical cancer.
Keywords
Cervical cancer; stage IIA; survival; radical hysterectomy;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Soisson AP, Soper JT, Clarke-Pearson DL, et al (1990). Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol, 37, 390-5.   DOI   ScienceOn
2 Steed H, Capstick V, Schepansky A, et al (2006). Early cervical cancer and parametrial involvement: is it significant? Gynecol Oncol, 103, 53-7.   DOI   ScienceOn
3 Sutton GP, Bundy BN, Delgado G, et al (1992). Ovarian metastases in stage IB carcinoma of the cervix: a Gynecologic Oncology Group study. Am J Obstet Gynecol, 166, 50-3.   DOI   ScienceOn
4 Trattner M, Graf AH, Lax S, et al (2001). Prognostic factors in surgically treated stage ib-iib cervical carcinomas with special emphasis on the importance of tumor volume. Gynecol Oncol, 82, 11-6.   DOI   ScienceOn
5 Verleye L, Vergote I, Reed N, et al (2009). Quality assurance for radical hysterectomy for cervical cancer: the view of the European Organization for Research and Treatment of Cancer--Gynecological Cancer Group (EORTC-GCG). Ann Oncol, 20, 1631-8.   DOI   ScienceOn
6 Pecorelli S, Zigliani L, Odicino F (2009). Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet, 105, 107-8.   DOI   ScienceOn
7 Mabuchi S, Okazawa M, Matsuo K, et al (2012). Impact of histological subtype on survival of patients with surgicallytreated stage IA2-IIB cervical cancer: adenocarcinoma versus squamous cell carcinoma. Gynecol Oncol, 127, 114-20.   DOI   ScienceOn
8 Macdonald OK, Chen J, Dodson M, et al (2009). Prognostic significance of histology and positive lymph node involvement following radical hysterectomy in carcinoma of the cervix. Am J Clin Oncol, 32, 411-6.   DOI   ScienceOn
9 Ngamcherttakul V, Ruengkhachorn I (2012). Ovarian metastasis and other ovarian neoplasms in women with cervical cancer stage IA-IIA. Asian Pac J Cancer Prev, 13, 4525-9.   DOI   ScienceOn
10 Perez CA, Grigsby PW, Chao KS, et al (1998). Tumor size, irradiation dose, and long-term outcome of carcinoma of uterine cervix. Int J Radiat Oncol Biol Phys, 41, 307-7.   DOI   ScienceOn
11 Peters WA, III, Liu PY, Barrett RJ, et al (2000). Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol, 18, 1606-13.
12 Quinn MA, Benedet JL, Odicino F, et al (2006). Carcinoma of the cervix uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet, 95, 43-103.   DOI   ScienceOn
13 Sakuragi N (2007). Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer. Int J Clin Oncol, 12, 165-75.   DOI
14 Shimada M, Kigawa J, Nishimura R, et al (2006). Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol, 101, 234-7.   DOI   ScienceOn
15 Hopkins MP, Morley GW (1991). Radical hysterectomy versus radiation therapy for stage IB squamous cell cancer of the cervix. Cancer, 68, 272-7.   DOI
16 Horn LC, Fischer U, Raptis G, et al (2007). Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer. Gynecol Oncol, 107, 310-5.   DOI   ScienceOn
17 Garg G, Shah JP, Toy EP, et al (2011). Stage IIA1 versus stage IIA2 cervical cancer: does the new staging criteria predict survival? Int J Gynecol Cancer, 21, 711-6.   DOI   ScienceOn
18 Ho CM, Chien TY, Huang SH, et al (2004). Multivariate analysis of the prognostic factors and outcomes in early cervical cancer patients undergoing radical hysterectomy. Gynecol Oncol, 93, 458-64.   DOI   ScienceOn
19 Hosaka M, Watari H, Mitamura T, et al (2011). Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy. Int J Clin Oncol, 16, 33-8.   DOI
20 Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.   DOI
21 Lai CH, Hsueh S, Hong JH, et al (1999). Are adenocarcinomas and adenosquamous carcinomas different from squamous carcinomas in stage IB and II cervical cancer patients undergoing primary radical surgery? Int J Gynecol Cancer, 9, 28-36.   DOI   ScienceOn
22 Lai JC, Chou YJ, Huang N, et al (2013). Survival analysis of Stage IIA1 and IIA2 cervical cancer patients. Taiwan J Obstet Gynecol, 52, 33-8.   DOI   ScienceOn
23 Landoni F, Maneo A, Colombo A, et al (1997). Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet, 350, 535-40.   DOI   ScienceOn
24 Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-7.   DOI   ScienceOn
25 Landoni F, Zanagnolo V, Lovato-Diaz L, et al (2007). Ovarian metastases in early-stage cervical cancer (IA2-IIA): a multicenter retrospective study of 1965 patients (a Cooperative Task Force study). Int J Gynecol Cancer, 17, 623-8.   DOI   ScienceOn
26 Covens A, Rosen B, Murphy J, et al (2002). How important is removal of the parametrium at surgery for carcinoma of the cervix? Gynecol Oncol, 84, 145-9.   DOI   ScienceOn
27 Delgado G, Bundy B, Zaino R, et al (1990). Prospective surgicalpathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol, 38, 352-7.   DOI   ScienceOn
28 Frumovitz M, Sun CC, Schmeler KM, et al (2009). Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer. Obstet Gynecol, 114, 93-9.   DOI   ScienceOn
29 Takeda N, Sakuragi N, Takeda M, et al (2002). Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet Gynecol Scand, 81, 1144-51.   DOI   ScienceOn