PROGNOSTIC FACTORS IN SURGICALLY TREATED STAGE IB-IIB CARCINOMA OF THE CERVIX WITH NEGATIVE LYMPH-NODES

Two hundred and seventy-five females with stage IB-IIB negative lymph node cervical cancer, treated between January 1988 and December 1994 b y radical hysterectomy and pelvic lymph node dissection, form the basi s of this analysis. The clinical records were reviewed for all patient s including histopathology, clinical features at presentation, and fol low-up. Tumors were re-staged according to the 1995 FIGO classificatio n. Median follow-up was 55 months and 85.8% were followed for longer t han two years. There were 21 recurrences, 12 of which were true centra l recurrence (disease-free survival at 5 years: 91.66%). Fifteen of 25 deaths were due to cervical cancer (crude survival at 5 years: 93.27% ). In univariate log-rank analysis, stage (P = 0.005), tumor size (P = 0.0002), and lymph-vascular space involvement (LVSI) (P = 0.01) appea red to be statistically significant factors for tumor recurrence. Othe r factors including age, histology type, differentiation, adjacent cer vical intraepithelial neoplasia or cervical glandular intraepithelial neoplasia, and presence of intraepithelial disease at resection margin were not found to be statistically significant. In multivariate analy sis (Cox regression) tumor size (P = 0.02) and LVSI (P = 0.03) were th e only independent variables. In the presence of negative lymph nodes and complete surgical excision, tumor size and LVSI are important pred ictors of local recurrence.