Clinical and pathological characteristics related to parametrial involvement in clinical early-stage cervical cancer

Abstract

Objectives: Since parametrial involvement is believed to be a crucial factor in the management of cervical cancer, our study was designed to investigate the clinical and pathological features which predicted parametrial involvement in patients with clinical early-stage cervical cancer.

Material and methods: The study included patients with clinical early-stage cervical cancer who underwent radical hys­terectomy with pelvic and para-aortic lymphadenectomy between December 2001 and August 2014, at the Hacettepe University Hospital. The clinical and pathological characteristics of the affected patients were evaluated, including age, histologic subtype, tumor size, depth of cervical stromal invasion, lympho-vascular space invasion (LVSI), and lymph node metastasis. Univariate and multivariate analyses were performed to reveal factors associated with parametrial involvement.

Results: The study group consisted of 126 patients (mean age: 52.7 years; range: 29–83), including 101 (80.2%) with squamous, 19 (15.1%) with adenocarcinoma, and 6 (4.8%) with adenosquamous histological subtype of cervical cancer. Parametrial involvement and lymph node metastasis were detected in 41 (32.5%) and 46 (36.5%) women, respectively. Univariate analysis showed that deep cervical stromal invasion, LVSI, tumor size > 2 cm and lymph node metastasis were associated with parametrial involvement. Multivariate logistic regression analysis identified the independent risk factors associated with parametrial involvement as LVSI (OR 8.93, 95% CI 1.1–73.5, p = 0.042) and lymph node metastasis (OR 8.8, 95% CI 1.5–9.3, p = 0.004).

Conclusions: LVSI, deep cervical stromal invasion, lymph node metastasis and tumor size are significantly associated with parametrial involvement in patients with clinical early-stage cervical cancer.