Multivariate analysis of prognostic factors in patients with stage IB cervical cancer who underwent radical hysterectomy

Taner Turan; Alev Özer; Abdullah Boztosun; Fatma Önalan; Nurettin Boran; Yetkin Karasu; Gökhan Tulunay; M. Faruk Köse

EN TR

Multivariate analysis of prognostic factors in patients with stage IB cervical cancer who underwent radical hysterectomy

Abstract

Abstract

Aim. The aim of this study was to assess the effects of prognostic factors on survival of cervical cancer patients. Methods. Data obtained from 193 patients who had been diagnosed as stage IB cervical cancer and underwent a type III radical hysterectomy and a systematic bilateral pelvic plus para-aortic lymphadenectomy between 1993 and 2007 were reviewed. Results. Twenty-three were excluded from the study as they have lost to follow-up immediately after surgery. Mean age was 53 years and median follow up was 62 months. During follow-up, recurrence was developed in 27 patients, while 26 died. In univariate analysis, the presence of metastasis in any lymph node, involvement of pelvic or para-aortic lymph nodes and adjuvant radiotherapy were significant factors in terms of disease free survival (DFS) and overall survival (OS) rate. Age and the lymphovascular space invasion were significant factors only for OS rate, whereas the depth of stromal invasion only for DFS rate. Tumor size, stage, cell type, grade, parametrial involvement, and positive surgical margins had no prognostic value. In multivariate analysis, presence of metastasis in any lymph node, pelvic lymph node involvement and age were found as independent prognostic factors for both DFS and OS. Stromal invasion was found as an independent prognostic factor only for DFS. However, no significance was found for para-aortic lymph node involvement, lymphovascular space invasion and adjuvant therapy. Conclusion. In the present study, only the lymph node status was an important factor among those determining patients with a high risk after early stage radical hysterectomy. Furthermore, it was found that age also had an important effect on survival rate as much as lymph node status had.

Key words: Cervical cancer, prognostic factors.

Özet

Amaç. Bu çalışmada serviks kanserinde prognostik etkisi olduğu düşünülen faktörlerin yaşam oranları üzerindeki etkisi değerlendirildi. Yöntem. 1993-2007 tarihleri arasında evre IB serviks kanseri tanısı alan, tip III radikal histerektomi ve sistematik bilateral pelvik+para-aortik lenfadenektomi geçiren 193 hastanın verileri gözden geçirildi. Bulgular. 23 hasta cerrahiden hemen sonra kontrollere gelmediğinden çalışma dışı bırakıldı. Değerlendirilen 170 hastanın yaş ortalaması 53 yıldı, ortanca takip süresi 62 aydı. Bu süre içinde 27 hastada nüks geliştiği ve 26 hastanın öldüğü belirlendi. Univaryant analizde herhangi bir lenf nodunda metastaz varlığı, pelvik veya para-aortik lenf nodu tutulumu ve adjuvan radyoterapi hastalıksız yaşam oranı (DFS) ve sağ kalım oranı (OS) için anlamlıydı. Yaş ve lenfovasküler alan invazyonu sadece OS için, stromal invazyon derinliğiyse sadece DFS için anlam taşımaktaydı. Tümör boyutu, evre, hücre tipi, grade , parametrial tutulum ve cerrahi sınır pozitifliğinin prognostik değerinin olmadığı görüldü. Multivaryant analizde ise herhangi bir lenf nodunda metastaz varlığı, pelvik lenf nodu tutulumu ve yaşın, hem DFS hemde OS için bağımsız prognostik faktörler olduğu saptandı. Stromal invazyon sadece DFS için bağımsız prognostik faktördü. Buna karşın para-aortik lenf nodu tutulumu, lenfovasküler alan invazyonu ve adjuvan radyoterapinin anlamlı olmadığı belirlendi. Sonuç. Bu çalışmada erken evrede radikal histerektomi sonrası yüksek-riskli grubu belirleyen faktörlerden sadece lenf nodu durumunun önemli olduğu görüldü. Bunun yanı sıra yaşın lenf nodu durumu kadar yaşam oranları üzerine etkili olduğu saptandı.

Anahtar sözcükler: Serviks kanseri, Prognostik faktörler

Keywords

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Original research-Orijinal araştırma

Öz

Amaç. Bu çalışmada serviks kanserinde prognostik etkisi olduğu düşünülen faktörlerin yaşam oranları üzerindeki etkisi değerlendirildi. Yöntem. 1993-2007 tarihleri arasında evre IB serviks kanseri tanısı alan, tip III radikal histerektomi ve sistematik bilateral pelvik+para-aortik lenfadenektomi geçiren 193 hastanın verileri gözden geçirildi. Bulgular. 23 hasta cerrahiden hemen sonra kontrollere gelmediğinden çalışma dışı bırakıldı. Değerlendirilen 170 hastanın yaş ortalaması 53 yıldı, ortanca takip süresi 62 aydı. Bu süre içinde 27 hastada nüks geliştiği ve 26 hastanın öldüğü belirlendi. Univaryant analizde herhangi bir lenf nodunda metastaz varlığı, pelvik veya para-aortik lenf nodu tutulumu ve adjuvan radyoterapi hastalıksız yaşam oranı (DFS) ve sağ kalım oranı (OS) için anlamlıydı. Yaş ve lenfovasküler alan invazyonu sadece OS için, stromal invazyon derinliğiyse sadece DFS için anlam taşımaktaydı. Tümör boyutu, evre, hücre tipi, grade , parametrial tutulum ve cerrahi sınır pozitifliğinin prognostik değerinin olmadığı görüldü. Multivaryant analizde ise herhangi bir lenf nodunda metastaz varlığı, pelvik lenf nodu tutulumu ve yaşın, hem DFS hemde OS için bağımsız prognostik faktörler olduğu saptandı. Stromal invazyon sadece DFS için bağımsız prognostik faktördü. Buna karşın para-aortik lenf nodu tutulumu, lenfovasküler alan invazyonu ve adjuvan radyoterapinin anlamlı olmadığı belirlendi. Sonuç. Bu çalışmada erken evrede radikal histerektomi sonrası yüksek-riskli grubu belirleyen faktörlerden sadece lenf nodu durumunun önemli olduğu görüldü. Bunun yanı sıra yaşın lenf nodu durumu kadar yaşam oranları üzerine etkili olduğu saptandı

Anahtar Kelimeler

Serviks kanseri, Prognostik faktörler

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Details

Primary Language

English

Subjects

-

Journal Section

-

Authors

Taner Turan

Alev Özer

Abdullah Boztosun

Fatma Önalan

Nurettin Boran

Yetkin Karasu

Gökhan Tulunay

M. Faruk Köse

Publication Date

December 23, 2010

Submission Date

November 11, 2009

Acceptance Date

-

Published in Issue

Year 1970 Volume: 32 Number: 4

IZ

https://izlik.org/JA35AN46TK

Cite

RIS / Bibtex

AMA

1.Turan T, Özer A, Boztosun A, et al. Multivariate analysis of prognostic factors in patients with stage IB cervical cancer who underwent radical hysterectomy. CMJ. 2010;32(4):303-314. https://izlik.org/JA35AN46TK