Effect of a T0 radical hysterectomy specimen on survival for early stage cervical cancer. Gynecol Oncol 2007 Nov;107(2):280-4
Date
08/19/2007Pubmed ID
17698175DOI
10.1016/j.ygyno.2007.06.013Scopus ID
2-s2.0-35348828775 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
OBJECTIVE: : Radical hysterectomy with regional lymphadenectomy is the surgical procedure of choice for stage IA-IIA cervical carcinoma. The goal of this study was to evaluate the outcome of patients with no residual tumor (T0) in their hysterectomy specimens.
METHODS: : An analysis of all women who underwent type II or III hysterectomy for invasive cervical cancer from 1989 to 2005 was performed. The pathologic data and clinical outcome of each patient was documented. T0 subjects were compared to the remainder of the cohort. Survival was evaluated with the Kaplan-Meier method.
RESULTS: : A total of 594 patients were identified. No residual tumor was noted in the hysterectomy specimens of 171 (29%). T0 patients had earlier stage tumors than the controls (IA 32%, IB 68%) (p<0.0001). Lymphadenectomy was performed in 89% of the T0 subjects. No T0 patients had lymphatic or parametrial disease. The median node yield was similar between the T0 group and those with residual tumors (24 vs. 25) (p=0.34). Adjuvant therapy was not administered to any of the T0 subjects. There were no recurrences and no cancer-related deaths in the T0 patients. Kaplan-Meier analysis revealed an improved disease free (p<0.0001) and overall survival (p<0.0001) for the T0 subjects compared to women with residual tumors. The results were similar when the analysis was restricted to stage IB1 patients (p=0.0004 and 0.002).
CONCLUSIONS: : A T0 radical hysterectomy specimen indicates a curative therapy. This subgroup of patients has a favorable prognosis with minimal risk of recurrence. Patients with T0 tumors may be candidates for less intensive, abbreviated follow-up.
Author List
Wright JD, Grigsby PW, Rader JS, Mutch DG, Powell MA, Gao F, Gibb RKAuthor
Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Carcinoma
Disease-Free Survival
Female
Humans
Hysterectomy
Kaplan-Meier Estimate
Lymph Node Excision
Middle Aged
Neoplasm Staging
Neoplasm, Residual
Retrospective Studies
Treatment Outcome
Uterine Cervical Neoplasms