Influence of tumor diameter on treatment results in cervical cancer patients

Abstract

The impact of the tumor size on treatment outcomes in cervical cancer patients remains a subject of controversy. Objectives: The assessment of prognostic value of pretreatment tumor size in cervical cancer patients. Materials and methods: Patients of Maria Sklodowska - Curie Memorial Cancer Centre in Warsaw, treated between January 1996 and December 2000, were included into the retrospective study. 242 patients were diagnosed with a histologically confi rmed squamous cell carcinoma and 42 with adenocarcinoma, FIGO staged IB-IVA, having undergone the clinical assessment and USG examination of the tumor, treated with curative intent with surgery and/ or radiotherapy. The widest tumor diameter was adopted as the tumor size. In most cases of adenocarcinoma, the tumors were described as endocervical and the tumor measurement was connected with the risk of mistake, therefore, the analysis of the squamous cell cancer patients only, was performed. A multivariate analysis of 242 patients with regard to overall survival (OS) and disease-free survival (DFS), depending on the selected clinico-pathological factors, was performed. The mean potential follow-up time for surviving patients was 50 months (range 8.7-62). The 5-year overall survival (OS) rate was 62%. Results: As the result of the multivariate analysis, the impact of FIGO stage (p=0.002), hemoglobin pretreatment concentration (p=0.031) and tumor size before treatment (p = 0.044) on OS, and FIGO stage (p=0.001), hemoglobin level before treatment (p=0.019) on DFS, was demonstrated. Conclusions: Tumor diameter before treatment in squamous cell cervical cancer patients provides important prognostic information, regardless of other prognostic factors.