Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer

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 cervica...

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Main Authors: Waroonsiri Hongladaromp, Charuwan Tantipalakorn, Kittipat Charoenkwan, Jatupol Srisomboon
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/53211
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-532112018-09-04T09:57:48Z Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer Waroonsiri Hongladaromp Charuwan Tantipalakorn Kittipat Charoenkwan Jatupol Srisomboon Biochemistry, Genetics and Molecular Biology Medicine 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. 2018-09-04T09:45:19Z 2018-09-04T09:45:19Z 2014-01-01 Journal 2476762X 15137368 2-s2.0-84894653884 10.7314/APJCP.2014.15.2.887 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84894653884&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/53211
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Biochemistry, Genetics and Molecular Biology
Medicine
spellingShingle Biochemistry, Genetics and Molecular Biology
Medicine
Waroonsiri Hongladaromp
Charuwan Tantipalakorn
Kittipat Charoenkwan
Jatupol Srisomboon
Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
description 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.
format Journal
author Waroonsiri Hongladaromp
Charuwan Tantipalakorn
Kittipat Charoenkwan
Jatupol Srisomboon
author_facet Waroonsiri Hongladaromp
Charuwan Tantipalakorn
Kittipat Charoenkwan
Jatupol Srisomboon
author_sort Waroonsiri Hongladaromp
title Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
title_short Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
title_full Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
title_fullStr Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
title_full_unstemmed Locoregional spread and survival of stage IIA1 versus stage IIA2 cervical cancer
title_sort locoregional spread and survival of stage iia1 versus stage iia2 cervical cancer
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84894653884&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/53211
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