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Factors associated with parametrial involvement in patients with stage IB1 cervical cancer: Who is suitable for less radical surgery?

Authors
Lee, S.-H.Cho, K.-J.Ko, M.-H.Cho, H.-Y.Lee, K.-B.Lim, S.
Issue Date
Jan-2018
Publisher
Korean Society of Obstetrics and Gynecology
Keywords
Hysterectomy; Uterine cervical neoplasms
Citation
Obstetrics and Gynecology Science, v.61, no.1, pp.88 - 94
Journal Title
Obstetrics and Gynecology Science
Volume
61
Number
1
Start Page
88
End Page
94
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/4308
DOI
10.5468/ogs.2018.61.1.88
ISSN
2287-8572
Abstract
Objective To detect the possible clinicopathologic factors associated with parametrial involvement in patients with stage IB1 cervical cancer and to identify a cohort of patients who may benefit from less radical surgery. Methods We retrospectively reviewed 120 patients who underwent radical hysterectomy and pelvic lymphadenectomy as treatment for stage IB1 cervical cancer. Results Overall, 18 (15.0%) patients had parametrial tumor involvement. Tumor size larger than 2 cm, invasion depth greater than 1 cm, presence of lymphovascular space involvement (LVSI), corpus involvement, and positive lymph nodes were statistically associated with parametrial involvement. Multivariate analysis for other factors showed invasion depth > 1 cm (P=0.029), and corpus involvement (P=0.022) were significantly associated with parametrial involvement. A subgroup with tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Conclusion Tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Invasion depth > 1 cm and corpus involvement were significantly associated with parametrial involvement in multivariate analysis. These finding may suggest that tumor size may a strong predictor of parametrial involvement in International Federation of Gynecology and Obstetrics stage IB1 cervical cancer, which can be used to select a subgroup population for less radical surgery. © 2018 Korean Society of Obstetrics and Gynecology.
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