Prognostic Factors in Stage IB Squamous Cervical Cancer Patients With Low Risk for Recurrence
About one-half of cervical cancer patients whose tumors recur after radical surgery have negative lymph nodes and clear resection margins. We evaluated 95 patients with squamous cell tumors who underwent radical hysterectomy and pelvic lymphadenectomy between January 1975 and December 1985 and who w...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 1991-02, Vol.77 (2), p.271-275 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | SMILEY, LINDA M. BURKE, THOMAS W. SILVA, ELVIO G. MORRIS, MITCHELL GERSHENSON, DAVID M. WHARTON, J. TAYLOR |
| description | About one-half of cervical cancer patients whose tumors recur after radical surgery have negative lymph nodes and clear resection margins. We evaluated 95 patients with squamous cell tumors who underwent radical hysterectomy and pelvic lymphadenectomy between January 1975 and December 1985 and who were thought to be at low risk for recurrence to see whether other clinical or histopathologic factors were predictive of tumor recurrence. Detailed retrospective record review and complete pathology review were accomplished for each case. The 5-year actuarial survival rate was 89%. Nine patients developed recurrent disease (9.5%), of whom eight died. Several clinical features were evaluated as possible prognostic factorspatient age (P=.26), patient race (P=.60), cervical diameter (P=.24), extent of gross cervical involvement (P=.36), and presence of contact bleeding (P=.82). Histopathologic features were examineddepth of invasion (P=.31), number of mitoses (P=.42), character of the tumor-stromal border (P=.15), histologic differentiation (P=.02), lymph-vascular space invasion (P=.56), and width of tumor (P=.23). Depth of invasion did correlate with increasing tumor width (P |
| doi_str_mv | 10.1097/00006250-199102000-00022 |
| format | Article |
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Several clinical features were evaluated as possible prognostic factorspatient age (P=.26), patient race (P=.60), cervical diameter (P=.24), extent of gross cervical involvement (P=.36), and presence of contact bleeding (P=.82). Histopathologic features were examineddepth of invasion (P=.31), number of mitoses (P=.42), character of the tumor-stromal border (P=.15), histologic differentiation (P=.02), lymph-vascular space invasion (P=.56), and width of tumor (P=.23). Depth of invasion did correlate with increasing tumor width (P<.001). Once node- and margin-positive patients are excluded, differentiation may be the only feature useful in identifying patients at risk for recurrence. Because almost one-half of our patients had poorly differentiated tumors, sole use of this feature as a criterion for adjuvant therapy would have resulted in overtreatment of low-risk patients.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/00006250-199102000-00022</identifier><identifier>PMID: 1988891</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>New York, NY: The American College of Obstetricians and Gynecologists</publisher><subject>Adult ; Biological and medical sciences ; Carcinoma, Squamous Cell - epidemiology ; Carcinoma, Squamous Cell - pathology ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Prognosis ; Risk Factors ; Survival Rate ; Tumors ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - pathology</subject><ispartof>Obstetrics and gynecology (New York. 1953), 1991-02, Vol.77 (2), p.271-275</ispartof><rights>1991 The American College of Obstetricians and Gynecologists</rights><rights>1991 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3852-9f0789146bd277d4c8ec3907b3f4ab7b07d601d077546b8658a624969fdfc1503</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19620044$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1988891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SMILEY, LINDA M.</creatorcontrib><creatorcontrib>BURKE, THOMAS W.</creatorcontrib><creatorcontrib>SILVA, ELVIO G.</creatorcontrib><creatorcontrib>MORRIS, MITCHELL</creatorcontrib><creatorcontrib>GERSHENSON, DAVID M.</creatorcontrib><creatorcontrib>WHARTON, J. TAYLOR</creatorcontrib><title>Prognostic Factors in Stage IB Squamous Cervical Cancer Patients With Low Risk for Recurrence</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>About one-half of cervical cancer patients whose tumors recur after radical surgery have negative lymph nodes and clear resection margins. We evaluated 95 patients with squamous cell tumors who underwent radical hysterectomy and pelvic lymphadenectomy between January 1975 and December 1985 and who were thought to be at low risk for recurrence to see whether other clinical or histopathologic factors were predictive of tumor recurrence. Detailed retrospective record review and complete pathology review were accomplished for each case. The 5-year actuarial survival rate was 89%. Nine patients developed recurrent disease (9.5%), of whom eight died. Several clinical features were evaluated as possible prognostic factorspatient age (P=.26), patient race (P=.60), cervical diameter (P=.24), extent of gross cervical involvement (P=.36), and presence of contact bleeding (P=.82). Histopathologic features were examineddepth of invasion (P=.31), number of mitoses (P=.42), character of the tumor-stromal border (P=.15), histologic differentiation (P=.02), lymph-vascular space invasion (P=.56), and width of tumor (P=.23). Depth of invasion did correlate with increasing tumor width (P<.001). Once node- and margin-positive patients are excluded, differentiation may be the only feature useful in identifying patients at risk for recurrence. Because almost one-half of our patients had poorly differentiated tumors, sole use of this feature as a criterion for adjuvant therapy would have resulted in overtreatment of low-risk patients.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - epidemiology</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - epidemiology</subject><subject>Uterine Cervical Neoplasms - pathology</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtPGzEQgC1ERdPAT0DyBW5L_Vo_jhCVghSpiIDaC7K8Xi9x2ayJ7W3Ev69pQumllixrPN-MR58BgBidYaTEZ1QWJzWqsFIYkRJVZROyByZYCloRSn_sg0m5UpWQjH0En1L6WRDMFT0AB1hJKRWegIebGB6HkLK38NLYHGKCfoCLbB4dvL6Ai_VoVmFMcObiL29ND2dmsC7CG5O9G3KC331ewnnYwFufnmAXIrx1dozRFewQfOhMn9zR7pyC-8svd7Orav7t6_XsfF5ZKmtSqQ6JMg3jTUuEaJmVzlKFREM7ZhrRINFyhFskRF0YyWtpOGGKq67tLK4RnYLTbd_nGNajS1mvfLKu783gyvBaIkYo47iAcgvaGFKKrtPP0a9MfNEY6Vez-s2s_mtW_zFbSo93b4zNyrXvhVuVJX-yy5tUPHWxePLpH4yXZowVjm25Teizi-mpHzcu6qUzfV7q_30s_Q3JyY7M</recordid><startdate>199102</startdate><enddate>199102</enddate><creator>SMILEY, LINDA M.</creator><creator>BURKE, THOMAS W.</creator><creator>SILVA, ELVIO G.</creator><creator>MORRIS, MITCHELL</creator><creator>GERSHENSON, DAVID M.</creator><creator>WHARTON, J. TAYLOR</creator><general>The American College of Obstetricians and Gynecologists</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199102</creationdate><title>Prognostic Factors in Stage IB Squamous Cervical Cancer Patients With Low Risk for Recurrence</title><author>SMILEY, LINDA M. ; BURKE, THOMAS W. ; SILVA, ELVIO G. ; MORRIS, MITCHELL ; GERSHENSON, DAVID M. ; WHARTON, J. 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Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SMILEY, LINDA M.</creatorcontrib><creatorcontrib>BURKE, THOMAS W.</creatorcontrib><creatorcontrib>SILVA, ELVIO G.</creatorcontrib><creatorcontrib>MORRIS, MITCHELL</creatorcontrib><creatorcontrib>GERSHENSON, DAVID M.</creatorcontrib><creatorcontrib>WHARTON, J. 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TAYLOR</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Factors in Stage IB Squamous Cervical Cancer Patients With Low Risk for Recurrence</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>1991-02</date><risdate>1991</risdate><volume>77</volume><issue>2</issue><spage>271</spage><epage>275</epage><pages>271-275</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract>About one-half of cervical cancer patients whose tumors recur after radical surgery have negative lymph nodes and clear resection margins. We evaluated 95 patients with squamous cell tumors who underwent radical hysterectomy and pelvic lymphadenectomy between January 1975 and December 1985 and who were thought to be at low risk for recurrence to see whether other clinical or histopathologic factors were predictive of tumor recurrence. Detailed retrospective record review and complete pathology review were accomplished for each case. The 5-year actuarial survival rate was 89%. Nine patients developed recurrent disease (9.5%), of whom eight died. Several clinical features were evaluated as possible prognostic factorspatient age (P=.26), patient race (P=.60), cervical diameter (P=.24), extent of gross cervical involvement (P=.36), and presence of contact bleeding (P=.82). Histopathologic features were examineddepth of invasion (P=.31), number of mitoses (P=.42), character of the tumor-stromal border (P=.15), histologic differentiation (P=.02), lymph-vascular space invasion (P=.56), and width of tumor (P=.23). Depth of invasion did correlate with increasing tumor width (P<.001). Once node- and margin-positive patients are excluded, differentiation may be the only feature useful in identifying patients at risk for recurrence. 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| ispartof | Obstetrics and gynecology (New York. 1953), 1991-02, Vol.77 (2), p.271-275 |
| issn | 0029-7844 1873-233X |
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| subjects | Adult Biological and medical sciences Carcinoma, Squamous Cell - epidemiology Carcinoma, Squamous Cell - pathology Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Medical sciences Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - pathology Neoplasm Staging Prognosis Risk Factors Survival Rate Tumors Uterine Cervical Neoplasms - epidemiology Uterine Cervical Neoplasms - pathology |
| title | Prognostic Factors in Stage IB Squamous Cervical Cancer Patients With Low Risk for Recurrence |
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