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Prognostic impact of tumour volume and lymph node involvement in intermediate stage T1b1 to T2b cancer of the uterine cervix |
Bulletin du Cancer. Volume 96, Number 6, 685-94, juin 2009, Article original
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Author(s) : G Goudy, E Stoeckle, L Thomas, M Kind, F Guyon, V Brouste, A Floquet |
Summary : ObjectiveDetermine the prognostic significance of tumour volume and pelvic lymph node status in intermediate stage T1b1 to T2b cancers of the uterine cervix.Patients and methodsMultivariate prognostic factor study in 219 patients (pts), median age 48 years, with stage T1b1 > 2 cm to T2b cervical cancers treated in 91% by primary radio- ± chemotherapy. All had a pretherapeutic laparoscopic pelvic lymphadenectomy, and 166 pts. had their tumour volume assessed by MRI. Patient and tumour characteristics were considered for analysis.ResultsSignificant prognostic variables in univariate analysis were the ASA anaesthetic score, stage T2b, tumour diameter, involvement of the uterine corpus, radiological (N1) and histological (N+) pelvic lymph node involvement and bilateral N+. Tumour volume was not significant. In multivariate analysis stage T2b (HR \= 2.5\; p \= 0.003), N+ (HR \= 3\; p \= 0.003) and bilateral N+ (HR \= 6.1\; p <\; 0.0001) were independent prognostic factors. Four prognostic groups according the existence of 0 to 3 prognostic factors showed their overall survivals declining from 97 to 27% (p <\; 0.0001).ConclusionStage T2b and pelvic lymph node involvement, but not tumour volume, are the major prognostic factors in intermediate stage cervical cancers. Pelvic lymph node involvement should be determined before treatment. |
Keywords : cancer of the uterine cervix, tumour volume, lymph node involvement, laparoscopic pelvic lymphadenectomy, magnetic resonance imaging, prognostic factors |
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