Prognostic factors in surgically treated stage Ib-IIb cervical carcinomas with special emphasis on the importance of tumor volume

Objective. The aim of the study was to analyze the importance of tumor volu me as a prognostic factor for overall survival (OS) in surgically treated s tage Ib-IIb cervical carcinoma. Methods. One hundred thirteen of one hundred sixty-five patients with histo pathological stage Ib-IIb cervical carcinoma (44 Ib1, 24 Ib2, 10 IIa, 35 II b) treated by radical abdominal hysterectomy between 1989 and 1999, for who m tumor volume could be assessed, were included in this study. Of the 113 p atients, 90 (79.6%) received postoperative radiotherapy. Measurement of tum or volume was performed on giant histological sections using a semiautomati c image analyzer. The prognostic significance of tumor volume was analyzed and compared with that of various clinicopathological parameters using uni- and multivariate statistics. Results. The 5-year disease-free survival was 71.4%. Increasing rumor volum e was associated with more frequent lymph node metastases and a significant decrease in OS (P = 0.0112). The Median tumor volume was smaller in stage IIa tumors than in stage Ib2 tumors, and histopathological stage did not co rrelate linearly with lymph node metastases as well as OS. Stage Ib2 tumors were associated with worse overall survival than stage IIa tumors. In univ ariate analysis, lymph node metastases, histopathological stage, lymph vasc ular space involvement, tumor volume, parametrial spread, and tumor involve ment of resection margins were significant parameters for OS. In multivaria te statistical analysis, only lymph node metastases and histopathological s taging remained independent prognostic factors for OS. Conclusions. Tumor volume does not seem to confer additional prognostic inf ormation if histopathological stage and lymph node status are known. Howeve r, it may provide important prognostic information if lymph node status is not known or histopathological stage cannot be assessed. (C) 2001 Academic Press.