Parametrial Invasion in Early-Stage Cervical Cancer

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Swita Luengyosluechakul
Amornrat Temtanakitpaisan
Chumnan Kietpeerakool
Bandit Chumworathayi
Pilaiwan Kleebkaow
Apiwat Aue-aungkul
Nampet Jampathong


Objective: to determine the rate of parametrial involvement and associated factors among patients who underwent radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer.

Materials and Methods: Medical records of 165 patients who had complete data were reviewed. Early stage cervical cancer was defined as cervical cancer stage IA2 to IIA. We excluded patients who presented with neuroendocrine tumors or sarcoma. The lesion size was measured clinically during pelvic examination preceding surgery.

Results:  The majority of patients (87.39%) were in stage IB1. One hundred twenty-five (75.8%) patients had tumors smaller than 2 cm in diameter. Pelvic lymph node metastases were noted in twelve (7.3%) patients. Parametrial invasion was noted in six (3.6%) patients.The rate of parametrial invasion was 10% among patients with tumors larger than 2 cm in diameter compared to 1.6% among those with smaller lesions.The rate of parametrial invasion was higher among patients who had deep stromal invasion (13.5% versus 0.9%) and pelvic node metastasis (41.7% versus 0.7%) compared to those without these two pathological factors.

Conclusion:  The overall rate of parametrial invasion in patients with early stage cervical cancer in this study was 3.6%.The one significant preoperative predictor for parametrial invasion was tumor size. Significant pathological factors for predicting an increased risk of parametrial invasion included the presence of deep stromal invasion and pelvic lymph node metastasis.


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