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KMID : 0358420070500060893
Korean Journal of Obstetrics and Gynecology
2007 Volume.50 No. 6 p.893 ~ p.900
Simplified prognostic factor scoring system in patients with lymph node-negative stage IB-IIA cervical cancer
Kim Ho-Yeon

Lyu Mi-Ok
Yoon Jong-Hyuck
Chang Suk-Joon
Chang Ki-Hong
Ryu Hee-Sug
Abstract
Objective: The aim of this study is to apply a prognostic factor scoring system in patients with lymph node-negative stage IB - IIA cervical cancer.

Methods: One hundred and ninety-one stage IB - IIA cervical cancer patients were enrolled in this retrospective study from 1994 to 2005 in our gynecologic department. All patients were treated by radical abdominal hysterectomy with lymph node dissection, and there were no patients with involvement of lymph nodes or parametrial invasion. Statistical analysis comprised of clinical characteristics, pathology result, post-operative adjuvant therapy, and recurrence rate.

Results: Among the 191 patients, recurrence occurred in 9 patients (4.7%), while no recurrence was observed in the remaining 182 patients (95.3%). No significant difference was found between the two study groups in terms of average age, weight, parity, FIGO stage, and postoperative adjuvant therapy. After univariate analysis, tumor size and deep stromal invasion were factors found to be statistically significant for risk of recurrence. Cell type, close surgical margin, lymphovascular permeation were not significant factors. Multivariate analysis demonstrated deep stromal invasion was the only significant prognostic factor (RR=11.7, p=0.028). The scoring system was applied to tumor size, close surgical margin, and deep stromal invasion, 1, 1, and 2 points given for each factor, respectively. Using the ROC curve, based on 2 points as the cut-off level, the recurrence rate was significantly higher (p<0.0025).

Conclusion: Deep stromal invasion was the most important prognostic factor in patients with early stage cervical cancer in the absence of lymph node metastasis. Herein, the scoring system may be applied to predict disease outcome.
KEYWORD
cervical cancer, prognosis, lymph node metastasis, Recurrence
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