Abstract
Objective
To examine characteristics and survival outcomes of women with surgically-treated
cervical cancer exhibiting uterine corpus tumor invasion.
Methods
We utilized The Surveillance, Epidemiology, and End Results Program to identify cervical
cancer patients who underwent hysterectomy between 1973 and 2003. Logistic regression
models were used to identify risk factors for uterine corpus tumor invasion on multivariable
analysis. Association of uterine corpus tumor invasion and cause-specific survival
(CSS) from cervical cancer was examined with Cox proportional hazard regression models
on multivariable analysis.
Results
We identified 837 (4.9%) cases of uterine corpus invasion and 16,237 (95.1%) cases
of non-invasion. Median follow-up time was 14.0 years. There were 1642 deaths due
to cervical cancer. Uterine corpus invasion was independently associated with older
age, non-squamous histology, high-grade tumors, large tumor size, and nodal metastasis
on multivariable analysis (all, P < 0.001). On univariable analysis, uterine corpus tumor invasion was significantly
associated with decreased CSS compared to the non-invasion (5-year rates, 79.0% versus 94.5%, P < 0.001). After controlling for other significant prognostic factors, uterine corpus
tumor invasion remained an independent prognostic factor for decreased CSS (adjusted-hazard
ratio 1.45, 95% confidence interval 1.21–1.74). Among stage T1b cases (n = 6730),
uterine corpus tumor invasion remained an independent prognostic factor for decreased
CSS (adjusted-hazard ratio 1.95, 95%CI 1.47–2.60). Uterine corpus tumor invasion was
significantly associated with decreased CSS in stage T1b1 disease (74.5% versus 90.7%, P < 0.001) and in stage T1b2 disease (67.0% versus 79.5%, P = 0.01).
Conclusion
Uterine corpus tumor invasion is an independent prognostic factor for decreased survival
of women with early-stage cervical cancer.
Keywords
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Article info
Publication history
Published online: February 03, 2017
Accepted:
January 24,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
