Oncologic outcome and recurrence patterns of clinical stage IB and IIA cervical cancer: A large retrospective analysis of a tertiary reference center

临床IB期和IIA期宫颈癌的肿瘤学预后和复发模式:一家三级转诊中心的大型回顾性分析

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Abstract

OBJECTIVE: To evaluate the outcomes and recurrence patterns and define the parameters that can help to predict high-risk patients among our 20-year clinical early-stage IB-IIA cervical cancer patients treated with traditional (non-nerve sparing) radical surgery. METHODS: This retrospective cohort study included 158 patients who had undergone traditional (non-nerve sparing) radical hysterectomy with pelvic lymph node dissection ± paraaortic lymph node dissection with clinical early-stage IB-IIA cervical cancer between January 2005 and July 2024 in our referral center. Descriptive statistics, survival analyses, and recurrence sites were evaluated. Furthermore, we researched independent risk factors for parametrial involvement and lymph node metastasis in these patients. RESULTS: The median follow-up time was 112 (1-288) months. The 5-year disease-free survival and overall survival rates in this study were 84% and 89%, respectively. There were two (1.2%) patients with local recurrence, four (2.4%) with regional, and seven (4.4%) patients with distant recurrence. According to multivariate logistic regression analyses, the only independent risk factor for regional and distant recurrences was lymph node metastasis. CONCLUSION: Traditional (non-nerve sparing) radical surgery appears to be safe and necessary to improve local control and decrease the local recurrence rate in clinical early-stage IB-IIA cervical cancer patients. We observed that lymph node metastasis was the only independent risk factor for regional and distant recurrences. However, there was no independent risk factor for local recurrence in patients with clinical stage IB-IIA cervical cancer.

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