Prognostic factors in stage IA-IIA cervical cancer patients treated surgically: does the waiting time to the operation affect survival?

Arch Gynecol Obstet. 2012 Feb;285(2):493-7. doi: 10.1007/s00404-011-1966-y. Epub 2011 Jul 7.

Abstract

Purpose: This study aimed to identify prognostic factors in patients with stage IA-IIA cervical cancer who had undergone radical surgery and clarify whether the waiting time to the operation affected the recurrence and survival outcome.

Materials and methods: We retrospectively reviewed the records of 117 patients who underwent surgical resection for stage IA-IIA cervical cancer. Patients were subdivided based on the waiting time from the initial visit to a gynecologist until surgery. Univariate analyses were performed to evaluate factors associated with recurrence-free and overall survival.

Results: The mean time from the first visit to surgery was 48 days (range 20-92). Recurrence-free and overall survival rates were not affected by the waiting time to the operation. On univariate analysis, lymph node metastasis (p = 0.003) and lymph-vascular space invasion (p = 0.015) were prognostic predictors of progression-free survival, while the waiting time to the operation was not (p = 0.106). Lymph node metastasis (p = 0.007), lymph-vascular space invasion (p = 0.046), and the histological diagnosis (p = 0.027) were prognostic predictors of overall survival, but the waiting time to the operation was not (p = 0.653).

Conclusions: The waiting time to the operation from the initial visit to surgical intervention does not adversely affect the outcome of cervical cancer within the time frames analyzed in this study. Furthermore, surgery allows the status of the lymph nodes and lymph-vascular space invasion, dependent variables associated with survival, to be assessed accurately.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Appointments and Schedules*
  • Carcinoma, Adenosquamous / pathology*
  • Carcinoma, Adenosquamous / secondary
  • Carcinoma, Adenosquamous / surgery
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery
  • Disease-Free Survival
  • Female
  • Humans
  • Hysterectomy*
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Retrospective Studies
  • Time Factors
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery
  • Young Adult