Risk for Radical Hysterectomy Failure

SUMONMAL MANUSIRIVITHAYA, M.D.*, VIRUCH CHAROENIAM, M.D.**, PAWA RES ISARIYODOM, M.D.**, AREE PANTUSART, B.Sc. **

Affiliation : * Department of Obstetrics and Gynecology, Bangkok Metropolitan Medical College and Vajira Hospital, Bangkok 10300, ** Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.

AbstractDuring the period from July 1983 to December 1996, 685 patients who underwent radical hysterectomy as their primary treatment for cervical cancer and had optimal follow-up _for at least three years were analyzed. Fifty seven patients (8.3%) had pelvic nodes metastasis and received postoperative whole pelvic radiation. Tumor recurrence was noted in 97 cases (14.2%). Nodal meta stasis is the most significant prognostic factor for tumor recurrence. Patients with nodal metastasis had 42.1 per cent risk of recurrence compared to 11.6 per cent in those without nodal metastasis. Furthermore; risk of recurrence significantly increased if more than 1 node was involved. Other factors associated with a significantly higher risk of recurrence in multivariate analysis were tumor histology and clinical stage. Patients with nonsquamous cell carcinoma and clinical stage Ila had disease recurrence in 24.4 per cent and 30.3 per cent compared to only 11.7 per cent in squamous and 13.3 per cent in stage lb. Tumor grade is the significant prognostic factor only in adenocar cinoma cell type but not in squamous cell type.

Keywords : Cervical Cancer, Radical Hysterectomy, Recurrence

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