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Use of preoperative clinicopathologic characteristics to identify patients with low‐risk cervical cancer suitable for Piver class II radical hysterectomy
Author(s) -
Xiong Ying,
Liu Jihong,
Zheng Min,
Cao Liping,
Liang Lizhi
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.01.026
Subject(s) - medicine , cervical cancer , radical hysterectomy , hysterectomy , stage (stratigraphy) , multivariate analysis , retrospective cohort study , cancer , single center , gastroenterology , surgery , urology , gynecology , paleontology , biology
Objective To investigate the long‐term efficacy of Piver–Rutledge class II radical hysterectomy (Piver II RH) for treatment of early‐stage cervical cancer and to identify suitable candidates for this procedure. Methods A retrospective study was conducted of 432 cervical cancer patients (tumor size ≤ 4 cm) treated with Piver II RH at Sun Yat‐sen University Cancer Center, Guangzhou, China, between January 1, 1999, and June 30, 2005. The correlation of preoperative and postoperative characteristics with recurrence and survival was analyzed. Results Median follow‐up was 72 months; the overall recurrence rate was 14.6%. The 5‐year recurrence‐free survival (RFS) was 88.0% and the 5‐year overall survival (OS) was 93.0%. Significant differences were observed between patients with small (≤ 2 cm) and large (> 2 cm) tumors with regard to intra‐pelvic recurrence (2.5% vs 13.4%; P = 0.001), extra‐pelvic recurrence (3.4% vs 9.9%; P = 0.028), RFS (95.0% vs 86.0%; P = 0.005), and OS (95.0% vs 87.0%; P = 0.005). Preoperative tumor size was the only factor that correlated with recurrence ( P = 0.018), RFS ( P = 0.038), and OS ( P = 0.029) in a multivariate analysis. Conclusion Cervical cancer patients with tumors of 2 cm or less were identified as candidates for Piver II RH, which promoted excellent local tumor control and long‐term survival.