Clinical outcomes and prognostic factors of node-negative cervical cancer patients with deep stromal invasion or lymphovascular space involvement following radical hysterectomy

Abstract

Objective: To evaluate the clinical outcomes and prognostic factors of node-negative cervical cancer patients who had deep stromal invasion (DSI) and/or lymphovascular space invasion (LVSI) following radical hysterectomy and pelvic lymphadenectomy (RHPL). Material and Method: The medical records of 150 node-negative stage IA2-IIA cervical cancer patients who had DSI and/or LVSI after RHPL from 1999 to 2004 were reviewed. Results: Eighty-eight (58.4%) patients were treated with RHPL alone. Twenty-eight (18.7%), 23 (15.4%), eight (5.3%), and three (2%) patients received postoperative chemotherapy, chemoradiation, radiotherapy, and brachytherapy, respectively. Overall, 11 (7.3%) patients developed recurrence. The estimated 5- year disease-free survival of the patients was 90.9%. By multivariate analysis, two factors, age of less than 35 years old and a non squamous histology, were significantly independent prognostic. Eight (5.3%) patients experienced treatment-related complications. Conclusion: Node-negative cervical cancer patients with DSI and/or LVSI had excellent clinical outcomes. Young age and non-squamous histology are significant independent prognostic factors.