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Trattner, M; Graf, AH; Lax, S; Forstner, R; Dandachi, N; Haas, J; Pickel, H; Reich, O; Staudach, A; Winter, R.
Prognostic factors in surgically treated stage ib-iib cervical carcinomas with special emphasis on the importance of tumor volume.
Gynecol Oncol. 2001; 82(1):11-16 Doi: 10.1006/gyno.2001.6252
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Co-authors Med Uni Graz: Dandachi Nadia; Haas Josef; Reich Olaf; Winter Raimund
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Abstract:: OBJECTIVE: The aim of the study was to analyze the importance of tumor volume as a prognostic factor for overall survival (OS) in surgically treated stage Ib-IIb cervical carcinoma. METHODS: One hundred thirteen of one hundred sixty-five patients with histopathological stage Ib-IIb cervical carcinoma (44 Ib1, 24 Ib2, 10 IIa, 35 IIb) treated by radical abdominal hysterectomy between 1989 and 1999, for whom tumor volume could be assessed, were included in this study. Of the 113 patients, 90 (79.6%) received postoperative radiotherapy. Measurement of tumor volume was performed on giant histological sections using a semiautomatic image analyzer. The prognostic significance of tumor volume was analyzed and compared with that of various clinicopathological parameters using uni- and multivariate statistics. RESULTS: The 5-year disease-free survival was 71.4%. Increasing tumor volume was associated with more frequent lymph node metastases and a significant decrease in OS (P = 0.0112). The Median tumor volume was smaller in stage IIa tumors than in stage Ib2 tumors, and histopathological stage did not correlate linearly with lymph node metastases as well as OS. Stage Ib2 tumors were associated with worse overall survival than stage IIa tumors. In univariate analysis, lymph node metastases, histopathological stage, lymph vascular space involvement, tumor volume, parametrial spread, and tumor involvement of resection margins were significant parameters for OS. In multivariate statistical analysis, only lymph node metastases and histopathological staging remained independent prognostic factors for OS. CONCLUSIONS: Tumor volume does not seem to confer additional prognostic information if histopathological stage and lymph node status are known. However, it may provide important prognostic information if lymph node status is not known or histopathological stage cannot be assessed.
Find related publications in this database (using NLM MeSH Indexing): Adenocarcinoma - classification Adenocarcinoma - pathology Adenocarcinoma - surgery; Adolescent -; Adult -; Aged -; Aged, 80 and over -; Carcinoma, Adenosquamous - classification Carcinoma, Adenosquamous - diagnosis Carcinoma, Adenosquamous - surgery; Carcinoma, Small Cell - classification Carcinoma, Small Cell - pathology Carcinoma, Small Cell - surgery; Carcinoma, Squamous Cell - classification Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery; Disease-Free Survival -; Female -; Humans -; Lymph Node Excision -; Lymph Nodes - pathology; Lymphatic Metastasis -; Middle Aged -; Neoplasm Staging -; Prognosis -; Uterine Cervical Neoplasms - classification Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - surgery
Find related publications in this database (Keywords): cervical carcinoma; cervical cancer; tumor volume; lymph node metastases; stage; radical hysterectomy; prognosis