The Survival after Surgery of Clinically Early-stage Cervical Cancer in Chonburi Hospital and Multivariable Analysis of Prognostic Factors Influencing Survival
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Abstract
Objectives: To evaluate 5-year overall survival (OS), 5-year disease-free survival (DFS), recurrent rate and identified prognostic clinicopathological factors of patients with clinically early-stage cervical cancer treated with primary surgery in Chonburi Hospital.
Materials and Methods: The medical records of early-stage cervical cancer patients undergoing surgery treatment from January 2012 to September 2023 were reviewed. OS and DFS were obtained. Patients’ age, stage, tumor size, histologic type, depth, degree of stromal invasion, lympho-vascular space invasion (LVSI), surgical margin, pelvic node status, and adjuvant treatment were assessed for correlation with DFS.
Results: Three hundred and twelve patients were included. The mean age was 46.8 ± 11.6 years, and the median follow-up was 67.0 months. Fifty-three patients (17.2%) developed recurrent disease. The 5-year OS was 100%, 93.9%, 88.5%, and 81.8% (p = 0.001) according to the International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA, IB1, IB2, and IB3, respectively. The 5-year DFS was 100%, 95.1%, 87.5%, and 74.5%, correspondingly (p = 0.001). The discordance between clinical and surgical upstaging was 13.8% according to FIGO 2018 criteria. In multivariate analysis, stage beyond IB3, tumor size over 4 cm, LVSI, and deep stromal invasion were significant prognostic variables. In contrast, adjuvant postoperative radiotherapy (PORT) in the intermediate and high-risk groups was the protective factor for DFS with a hazard ratio of 0.39 [0.20 – 0.76, p = 0.006].
Conclusion: The 5-year OS and DFS of clinically early-stage cervical cancer were 85.3% and 84.0%, respectively. PORT was the protective factor for recurrence.
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