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KMID : 0358419960390101956
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Korean Journal of Obstetrics and Gynecology
1996 Volume.39 No. 10 p.1956 ~ p.1962
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A Retrospective Comparative Study for Clinical Characteristics and Prognostic Factors in Stage Ib, Iia Cervical Carcinoma Patients Who Underwnet Primary Surgery or Primary Radiotherapy
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정동훈
최석철/곽정아/김종훈/김병기/박상윤/이의돈/이경희/박기복
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Abstract
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Purpose:
@EN This nonrandomized retrospective study was performed to compare clinical characteristics and prognostic fators in patients with Stage Ib, IIa cervical carcinoma who underwent primary surgery or primary radiotherapy.
@ES Materials and Methods:
@EN 222 evaluable patients with stage Ib, IIa carcinoma of the uterine cervix were treated at the Korea Cancer Center Hospital from January 1987 to March 1988. In this retrospective analysis, we compared treatment results obtained by surgery
alone(group
S, 88 patients), surgery followed by radiation(group SR, 56 patients), or radiotherapy alone(group R, 78 patients). Postoperative adjuvant irradiation was performed in cases with positive resection margin, lymph node metastasis(e), outer 1/3
tumor
involvement of cervical wall, parametrial tumor involvement at pathologic examination, or primary bulky tumor larger than 4 cm in diameter. Patients with medical illness, older than 65 years, obesity, and who refused for surgery were treated with
primary radiotherapy. In this study, the 5-year disease free survival rate(5-YDFSR) and the clinical characteristics of recurrence were compared among threegroups of patients and with the prognostic factors in group S & SR.
@ES Result:
@EN The 5-YDFSR according to treatment modalities were 98.5% in group S, 85.2% in group SR, and 79.6% in group R(p<0.05). distant recurrence rate(77.8% ; 7/9) in Group S and SR was more common than that(31.2% ; 5/16) in Group R(p<0.05). In this
study,
the only singnificant prognostic factor in patients with stage Ib, IIa cervical carcinoma was identified as lymph node metastasis(e)(p=0.0001). The was no significant difference in 5-YDFSR according to tumor size, histologic type, age, depth of
invasion, tumor involvement of resection margin, and FIGO stage(p>0.05).
@ES Conclusion:
@EN Although this study was performed retrospectively, these results may suggest that the patients who did not have any risk factors showed the highest survival rate regardles of treatment modalities. This suggestion must be elucidated by further
randomized prospective study.
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KEYWORD
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