Risk Factors Associated with Parametrial Involvement in Early-stage Cervical Cancer

Abstract

Objectives: The study aimed to identify the risk factors affecting parametrial involvement in patients with early-stage cervical cancer.
Materials and Methods: The sample participated in the study was the patients with stage IA2 to IIA1 cervical cancer according to 2018 International Federation of Gynecology and Obstetrics (FIGO), who had been treated with radical hysterectomy and pelvic lymphadenectomy during April 2011 to April 2020. In term of methodology, the retrospective cross-sectional analysis was to determine the factors including tumor size, deep stromal invasion (DSI), lymphovascular space invasion (LVSI), pelvic node status, FIGO staging, age and histology (squamous cell carcinoma, adenocarcinoma and adenosquamous cell carcinoma), associated with parametrial involvement (PI).
Results: Overall, 19 of the 206 patients (9.22%) had PI. Patients with PI were more likely to have larger tumor size (> 4 cm: 15%, 2-4 cm: 10%, < 2 cm: 2%, p = 0.02), DSI (deep 1/3: 19%, middle 1/3: 2%, superficial 1/3: 0%, p = 0.01), LVSI (positive: 17%, negative: 3%, p < 0.01), metastasis to pelvic lymph nodes (positive: 50%, negative: 4%, p < 0.01), and higher FIGO stage (IB3: 16%, IB2: 10%, IB1: 3%, IA2: 0%, p = 0.02). Multivariate analysis showed that only deep stromal invasion (p = 0.02) and pelvic lymph node metastasis (p < 0.01) were independent risk factors for PI.
Conclusion: The deep stromal invasion and pelvic lymph node involvement were significantly associated with PI in multivariate analysis. Cervical cancer with superficial 1/3 stromal invasion and no pelvic lymph node metastasis seldom had PI.