Pathologic Risk Factors and Oncologic Outcomes in Early-stage Cervical Cancer Patients Treated by Radical Hysterectomy and Pelvic Lymphadenectomy at a Thai University Hospital: A 7 year Retrospective Review

Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatmentoutcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy(RHPL). Materials and
Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPLduring the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed.
Results: Of331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-riskfactors without high-risk factors. All studied patients had an initial complete response. At median follow-up timeof 40.9 months (range 1-103.3 months) and mean follow-up time of 43.3±25.3 months, 37 women had diseaserecurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Fiveyearand 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overallsurvival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic nodemetastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI,1.483-9.549).
Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be consideredand disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primarysurgical treatment for early-stage cervical carcinoma were found to be excellent.