본문 바로가기
KERD
논문KCI 등재

Factors associated with parametrial involvement in patients with stage IB1 cervical cancer: who is suitable for less radical surgery?

조경주|조현이|이광범|임소이|이승호|고미향
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2018.01|Obstetrics & Gynecology Science|제61권 제1호|pp. 88-94|DOI https://doi.org/10.5468/ogs.2018.61.1.88

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

HysterectomyUterine cervical neoplasms
주제분류산부인과학

초록

Objective To detect the possible clinicopathologic factors associated with parametrial involvement in patients with stage IB1 cervical cancer and to identify a cohort of patients who may benefit from less radical surgery. Methods We retrospectively reviewed 120 patients who underwent radical hysterectomy and pelvic lymphadenectomy as treatment for stage IB1 cervical cancer. Results Overall, 18 (15.0%) patients had parametrial tumor involvement. Tumor size larger than 2 cm, invasion depth greater than 1 cm, presence of lymphovascular space involvement (LVSI), corpus involvement, and positive lymph nodes were statistically associated with parametrial involvement. Multivariate analysis for other factors showed invasion depth >1 cm (P=0.029), and corpus involvement (P=0.022) were significantly associated with parametrial involvement. A subgroup with tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Conclusion Tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Invasion depth >1 cm and corpus involvement were significantly associated with parametrial involvement in multivariate analysis. These finding may suggest that tumor size may a strong predictor of parametrial involvement in International Federation of Gynecology and Obstetrics stage IB1 cervical cancer, which can be used to select a subgroup population for less radical surgery.

Abstract

Objective To detect the possible clinicopathologic factors associated with parametrial involvement in patients with stage IB1 cervical cancer and to identify a cohort of patients who may benefit from less radical surgery. Methods We retrospectively reviewed 120 patients who underwent radical hysterectomy and pelvic lymphadenectomy as treatment for stage IB1 cervical cancer. Results Overall, 18 (15.0%) patients had parametrial tumor involvement. Tumor size larger than 2 cm, invasion depth greater than 1 cm, presence of lymphovascular space involvement (LVSI), corpus involvement, and positive lymph nodes were statistically associated with parametrial involvement. Multivariate analysis for other factors showed invasion depth >1 cm (P=0.029), and corpus involvement (P=0.022) were significantly associated with parametrial involvement. A subgroup with tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Conclusion Tumor size smaller than 2 cm showed no parametrial involvement, regardless of invasion depth or presence of LVSI. Invasion depth >1 cm and corpus involvement were significantly associated with parametrial involvement in multivariate analysis. These finding may suggest that tumor size may a strong predictor of parametrial involvement in International Federation of Gynecology and Obstetrics stage IB1 cervical cancer, which can be used to select a subgroup population for less radical surgery.

참고문헌 (21)

  1. Covens A, "How important is removal of the parametrium at surgery for carcinoma of the cervix?", Gynecol Oncol, 84, pp.145~149 (2002)[DOI]
  2. Benedetti-Panici P, "Early cervical carcinoma: the natural history of lymph node involvement redefined on the basis of thorough parametrectomy and giant section study", Cancer, 88, pp.2267~2274 (2000)[DOI]
  3. Delgado G, "A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study", Gynecol Oncol, 35, pp.314~320 (1989)[DOI]
  4. 노주원, "Efficacy and oncologic safety of nerve-sparing radical hysterectomy for cervical cancer: a randomized controlled trial", Journal of Gynecologic Oncology, 26(2), pp.90~99 (2015), 대한부인종양학회
  5. Kim MK, "Feasibility of less radical surgery for superficially invasive carcinoma of the cervix", Gynecol Oncol, 119, pp.187~191 (2010)[DOI]
  6. Kodama J, "Factors associated with parametrial involvement in stage IB1 cervical cancer and identification of patients suitable for less radical surgery", Gynecol Oncol, 122, pp.491~494 (2011)[DOI]
  7. Winter R, "Parametrial spread of cervical cancer in patients with negative pelvic lymph nodes", Gynecol Oncol, 84, pp.252~257 (2002)[DOI]
  8. Puente R, "Do the pelvic lymph nodes predict the parametrial status in cervical cancer stages IB-IIA", Int J Gynecol Cancer, 14, pp.832~840 (2004)[DOI]
  9. Kamimori T, "Parametrial involvement in FIGO stage IB1 cervical carcinoma diagnostic impact of tumor diameter in preoperative magnetic resonance imaging", Int J Gynecol Cancer, 21, pp.349~354 (2011)
  10. Frumovitz M, "Parametrial involvement in radical hysterectomy specimens for women with earlystage cervical cancer", Obstet Gynecol, 114, pp.93~99 (2009)[DOI]
  11. Wright JD, "Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy", Cancer, 110, pp.1281~1286 (2007)[DOI]
  12. Smith AL, "Conservative surgery in earlystage cervical cancer: what percentage of patients may be eligible for conization and lymphadenectomy", Gynecol Oncol, 119, pp.183~186 (2010)[DOI]
  13. Stegeman M, "The incidence of parametrial tumor involvement in select patients with early cervix cancer is too low to justify parametrectomy", Gynecol Oncol, 105, pp.475~480 (2007)[DOI]
  14. Steed H, "Early cervical cancer and parametrial involvement: is it significant", Gynecol Oncol, 103, pp.53~57 (2006)[DOI]
  15. Candido EB, "Histopathological and immunohistochemical (cytokeratins AE1", AE3) study of the parametrium of patients with early stage cervical cancer, 2008, pp.141, 58~63
  16. van den Tillaart SA, "Patterns of parametrial involvement in radical hysterectomy specimens of cervical cancer patients", Int J Gynecol Pathol, 30, pp.185~192 (2011)
  17. Girardi F, "The importance of parametrial lymph nodes in the treatment of cervical cancer", Gynecol Oncol, 34, pp.206~211 (1989)[DOI]
  18. Burghardt E, "Local spread and lymph node involvement in cervical cancer", Obstet Gynecol, 52, pp.138~145 (1978)
  19. Chen GD, "Urinary tract dysfunction after radical hysterectomy for cervical cancer", Gynecol Oncol, 85, pp.292~297 (2002)[DOI]
  20. Landoni F, "Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study", Gynecol Oncol, 80, pp.3~12 (2001)[DOI]
  21. Panici PB, "Tailoring the parametrectomy in stages IA2-IB1 cervical carcinoma: is it feasible and safe", Gynecol Oncol, 96, pp.792~798 (2005)[DOI]

이 간행물의 다른 논문 (11건)

Antenatal corticosteroids and outcomes of preterm small-for-gestational-age neonates in a single medical center위정하, 박인양, 고현선, 한영신, 김우정, 신종철pp. 7-13Evaluation of nausea and vomiting in pregnancy using the Pregnancy-Unique Quantification of Emesis and Nausea scale in Korea최현정, 한정열, 안현경, 안현숙, 홍달수, 윤정섭, 배윤주, 최준식pp. 30-37Prevalence of vaginal microorganisms among pregnant women according to trimester and association with preterm birth손경아, 최석주, 오수영, 노정래, 김종화, 김민지, 김유민, 김수현pp. 38-47Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in ThailandNalat Sompagdee, Khemanat Khemworapong, Dittakarn Boriboonhirunsarnpp. 48-55Efficacy of luteal estrogen administration and an early follicular Gonadotropin-releasing hormone antagonist priming protocol in poor responders undergoing in vitro fertilization차선화, 이현정, 김민정, 양광문, 이화정, 최현정pp. 102-110
원문 보기