Prognostic factors affecting survival and recurrence in patients with early cervical squamous cell cancer following radical hysterectomy

J Int Med Res. 2020 Apr;48(4):300060519889741. doi: 10.1177/0300060519889741. Epub 2019 Dec 31.

Abstract

Objective: This study aimed to investigate the clinical and histological features affecting the survival of patients with early cervical squamous cell cancer treated with radical hysterectomy.

Methods: We retrospectively analyzed clinical and histological data for patients with stage IB-IIA cervical cancer treated by radical hysterectomy at Zhejiang Cancer Hospital from August 2008 to January 2013.

Results: A total of 1435 patients were included in the study. Cox regression analysis identified tumor size >4 cm, lymphovascular space involvement (LVSI), lymph node ratio (LNR), and squamous cell carcinoma antigen (SCC-Ag) >2.65 ng/mL as independent prognostic risk factors. Among 1096 patients without high pathological risk factors, the 5-year local recurrence rates for SCC-Ag ≤2.65 and >2.65 ng/mL were 6.6% and 25.7%, respectively. Among 332 patients with lymph node positivity, the overall survival rates for LNR ≤0.19 and >0.19 were 87.8% and 55.6%, respectively.

Conclusions: LVSI, tumor size >4 cm, LNR >0.19, and SCC-Ag >2.65 ng/mL may predict a poor prognosis in patients with early cervical squamous cell cancer treated with radical hysterectomy. SCC-Ag >2.65 ng/mL may be a useful prognostic factor guiding the use of postoperative radiotherapy in patients without pathologic risk factors.

Keywords: Lymph node ratio; antigen; prognosis; radiotherapy; squamous cell carcinoma; tumor size; uterine cervical neoplasm.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Humans
  • Hysterectomy
  • Lymphatic Metastasis
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms* / pathology
  • Uterine Cervical Neoplasms* / surgery