IDENTIFICATION OF HIGH-RISK GROUPS AMONG NODE-POSITIVE PATIENTS WITH STAGE IB AND IIA CERVICAL-CARCINOMA

The purpose of the present study was to identify a subset of high-risk patients among surgically treated node-positive patients with stage I B and IIA cervical carcinoma. From 1982 through 1991, 334 patients und erwent radical hysterectomy for FIGO stage IB and IIA cervical carcino ma. In 68 patients pathological analysis of the surgical specimen reve aled positive pelvic nodes. In this group, a Cox proportional hazard a nalysis was performed to examine the prognostic significance of clinic opathological variables. Only for adenocarcinoma (P = 0.002) and param etrium infiltration (P = 0.003) was evidence of an association with pr ognosis found. Based on these two factors, patients with positive pelv ic nodes were categorized into a low-risk group (squamous cell carcino ma without parametrium infiltration, N = 33) and a high-risk group (sq uamous cell carcinoma with parametrium infiltration or adenocarcinoma, N = 34). The 5-year disease-specific survival in the low-risk group w as 94% compared with 60% in the high-risk group (P = 0.003). For patie nts in the high-risk group, there is an urgent need for alternative ad juvant treatment to improve outcome. (C) 1997 Academic Press.