Abstract
Objective
To explore the clinicopathological risk factors influencing parametrial involvement
(PI) in stage IB cervical cancer patients and compare the oncological outcomes between
Q-M type B radical hysterectomy (RH) group and Q-M type C RH group.
Methods
Univariate and multivariate analyses were performed to explore the clinicopathological
factors related to PI. Overall survival (OS) and disease-free survival (DFS) in patients
with stage IB cervical cancer who underwent Q-M type B or Q-M type C RH under different
circumstances of PI were also compared before and after propensity score matching
(1:1 matching).
Results
A total of 6358 patients were enrolled in this study. Depth of stromal invasion>1/2
(HR: 3.139, 95% CI: 1.550–6.360; P = 0.001), vaginal margin (+) (HR: 4.271, 95% CI: 1.368–13.156; P = 0.011), lymphovascular space invasion (LVSI) (+) (HR: 2.238, 95% CI: 1.353–3.701;
P = 0.002) and lymph node metastases (HR: 5.173, 95% CI: 3.091–8.658; P < 0.001) were associated with PI. Among the 6273 patients with negative PI, those
in the Q-M type B RH group had a higher 5-year OS and DFS than those in the Q-M type
C RH group before and after 1:1 matching. Among the 85 patients with positive PI,
Q-M type C RH showed no survival benefits before and after 1:1 matching.
Conclusion
Stage IB cervical cancer patients with no lymph node metastasis, LVSI(−) and depth
of stromal invasion ≤1/2 may be considered for Q-M type B radical hysterectomy.
Keywords
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Article info
Publication history
Published online: May 18, 2023
Accepted:
May 17,
2023
Received in revised form:
May 7,
2023
Received:
January 17,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
