Prognostic factors and failure pattern in lymph node-negative stage IB andII cervical carcinoma treated with radical hysterectomy and postoperative irradiation

The aim was to determine the prognostic factors and recurrence pattern in s tages IB and II cervical carcinoma patients with negative pelvic lymph node s. 224 patients with stages IB and II cervical carcinoma underwent radical hysterectomy (RH) from 1982 through 1995. Of 161 patients with negative lym ph nodes, 65 patients received postoperative irradiation (RT) and 96 patien ts were given no further therapy according to surgical pathological finding s. The overall 5-year disease-free survival was 94.1%. Two of 96 RH patient s (2%) and 10 of 65 RH + RT patients (15%) had recurrence in pelvic and dis tant sites almost equally. Multivariate analysis revealed deep cervical inv asion as the only independent prognostic factor. The 5-year disease-free su rvival was 98.8% for patients with shallow invasion and 85.8% for patients with deep invasion (p < 0.0001). It is worthwhile to develop new strategies for the lymph node-negative patients with deep stromal invasion. Copyright (C) 2001 S. Karger AG, Basel.