One hundred fifty-seven patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February 1975 and May 1987 were retrospectively analysed to identify specific risk factors
associated with treatment failures.
Prognostic factors included clinical stage, histologic cell type. degree of differentiation, size of primary tumor, depth of stromal invasion, lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year
absolute
recurrence-free survival(NED) rate by the prognostic factors and factors and treatment modalities.
Patients with lymph node metastases had a significantly higher incidence of bulky primary((4cm), depth of stromal invasion((60^ thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year
NED
rate
between cervical carcinoma stage IB and IIA(P<0.005).
The patients who had bulky primary tumor((4cm) and/or depth of stromal invasion((60% thickness) had a higher recurrence and lower 2-year NED rate(P<0.025, P<0.005). Unfortunately, it was not possible to demonstrate that these detrimental effects
could
be overcome by postoperative radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lymph-vascular invasion assume less importance in our studies.
In this study, prognosis is most influenced by clinical stage, depth of stromal invasion, and size of primary tumor.
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