Prognostic Model in Patients with Early-stage Squamous Cell Carcinoma of the Uterine Cervix: A Combination of Invasive Margin Pathological Characteristics and Lymphovascular Space Invasion

Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamouscell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and
Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamouscell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. Inaddition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type ofinvasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also includedin the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction ofrecurrence and decreased survival was selected.
Results: The model with the best performance was composed of acombined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reactionand stromal desmoplasia (total score =10). Compared to those with score ≤8, the patients with score 9-10 had asignificantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy(p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition,the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-freesurvival was significantly lower in the patients with score 9-10 than those with score ≤8 among the overallpatients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy(p=0.047).
Conclusions: In this study, a prognostic model based on a combination of pathological characteristicsof invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survivalin patients with early-stage cervical squamous cell carcinoma.