Clinical Outcomes and Prognostic Factors of Node - Negative Cervical Cancer Patients with Deep Stromal Invasion or Lymphovascular Space Involvement Following Radical Hysterectomy
Prapaporn Suprasert MD*, Jatupol Srisomboon MD*, Sumalee Siriaunkgul MD**, Surapan Khunamornpong MD**, Chailert Phongnarisorn MD*, Sitthicha Siriaree MD*, Kittipat Charoenkwan MD*, Chalong Cheewakriangkrai MD*, Chumnarn Kietpeerakool MD*
Affiliation : * Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai ** Division of Gynecologic Pathology, Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To evaluate the clinical outcomes and prognostic factors of node-negative cervical cancer patients
who had deep stromal invasion (DSI) and/or lymphovascular space invasion (LVSI) following radical
hysterectomy and pelvic lymphadenectomy (RHPL).
Materials and Methods : The medical records of 150 node-negative stage IA2-IIA cervical cancer patients who
had DSI and/or LVSI after RHPL from 1999 to 2004 were reviewed.
Results : Eighty-eight (58.4%) patients were treated with RHPL alone. Twenty-eight (18.7%), 23 (15.4%),
eight (5.3%), and three (2%) patients received postoperative chemotherapy, chemoradiation, radiotherapy,
and brachytherapy, respectively. Overall, 11 (7.3%) patients developed recurrence. The estimated 5- year
disease-free survival of the patients was 90.9%. By multivariate analysis, two factors, age of less than 35
years old and a non squamous histology, were significantly independent prognostic. Eight (5.3%) patients
experienced treatment-related complications.
Conclusion : Node-negative cervical cancer patients with DSI and/or LVSI had excellent clinical outcomes.
Young age and non-squamous histology are significant independent prognostic factors.
Keywords : Cervical cancer, Deep stromal invasion, Lymph vascular space invasion
