EARLY-STAGE CERVICAL-CANCER - A MULTIVARIATE-ANALYSIS OF HISTOPATHOLOGICAL PROGNOSTIC FACTORS

A multivariate analysis of the histopathological prognostic factors in early stage carcinoma of the cervix was performed. A total of 140 pat ients were studied (Stage 1A 6, Stage 1B 107, Stage 2A 27 patients). F ive-year follow-up data were available for 124 patients and 10-year da ta for 76 patients. The histopathological factors considered were the histological type, lymph node metastases, tumour diameter, lymph vascu lar space invasion, parametrial invasion and corpus and vaginal invasi on. Multivariate analysis identified lymph node metastases (p = 0.0003 ) and tumour diameter (p = 0.0016) as significant variables for surviv al at 5 and 10 years. There was a high incidence of occult parametrial invasion (20% in Stage 1B and 37% in Stage 2A). Univariate analysis i dentified lymph node metastases (p < 0.0001), tumour diameter (p < 0.0 001), lymph vascular space invasion (p = 0.0041) and parametrial invas ion (p = 0.0024) as significant variables for survival at 5 years, wit h lymph node metastases, tumour diameter, lymph vascular space invasio n remaining significant at 10 years. If there were 2 or more pelvic ly mph node metastases the survival decreased considerably (up to 40% ove r 5 years). Microscopic parametrial invasion was identified in 20% of Stage 1B and 37% of Stage 2A tumours. The critical period for recurren ce was the first 2 years after surgery.