Does FIGO clinical stage influence the survival of patients with early stages of uterine cervix carcinoma

We studied the influence of the FIGO clinical stage on the prognosis of 114 patients with early stages of uterine cervix carcinoma who had been treated with radical surgery in the "La Fe" Maternity Hospital in Valencia between 1971 and 1989. The prognosis became worse with each clinical stage, in line with the fact that the more advanced clinical stages are more likely to have certain types of spread, larger tumours and a greater stromal invasion depth. However, the Cox regression adjustment of the variables predicting disease-free and survival intervals, including the clinical stage and preoperative and postoperative treatment, did not reveal a significant link between clinical stage and the prognostic indices studied, while postoperative treatment variables showed a great predictive capacity, possibly due to the fact that the postoperative treatment used in more advanced stages is more aggressive.

Clinical stage; Cervix cancer; Radical surgery; Prognosis

[1] "Cervical and vulvar cancer: changes in FIGO definitions of staging". Br. J. Obstet. Gynecol., 1996, 103, 405.

[2] Finan M.A., Decesare S., Fiorica J. V., et al.: "Radical hysterectomy for stage lb! versus lb2. Carcinoma of the cervix: should the new FIGO staging system define therapy?". Gynecol. Oneal., 1996, 62, 139.

[3] Grisby P. W.: "Stage lb! versus Ib2. Carcinoma of the cervix: should the new FIGO staging system define therapy?". Gynecol Oncol., 1996, 62, 135.

[4] Werner-Wasik M., Schmid C.H., Bornstein L., et al.: "Prognostic factors for local and distant recurrence in stage I and II cervical carcinoma". Int. J. Radial. Oneal. Biol. Phys., 1995, 32, 109.

[5] Canistra S., Niloff J.M.: "Cancer of the uterine cervix". N. Engl. J. Med., 1996, 334, 1030.

[6] Inoue T., Okumura M.: "Prognostic significance of parametrial extension in patients with cervical carcinoma Stages lb, Ila, and IIb: a study of 628 cases treated by radical hysterectomy and lymphadenectomy with or without postoperative irradiation" Cancer, 1984, 54, 1714.

[7] Burghardt E.,H aas J., Girardi F.:'The significance of the parametrium in the operative treatment of the cervical cancer". Bailliere's Clin. Obstet. Gynaecol., 1988, 2, 879.

[8] Baltzer J., Koepcke W.: "Tumor size and lymph node metastases in squamous-cell carcinoma of the uterine cervix". Arch. Gynecol., 1979, 227, 271.

[9] Burghardt E., Pickel H.: "Local spread and lymph node involvement in cervical cancer". Obstet. Gynecol., 1978, 52, 138.

[10] Burghardt E., Baltzer J.,T ulusan H.,H aas J.: "Results of surgical treatment of I 028 cervical cancers studied with volumetry". Cancer, 1992, 10, 648.

[11] Burghardt E.: "Pathology of preclinical invasive carcinoma (microinvasive and occult invasive carcinoma)". In: Coppleson M. (ed.): "Gynecologic Oncology". Edinburgh: Livingstone, 1981, 434.

[12] Coia L., Won M.. Lanciano R., et al.: "The Patterns of Care Outcome Study for cancer of the uterine cervix: Results of the 2'"' National Practice Survey". Cancer, 1990, 66, 2451.

[13] Bolla M., Grand E., Sal vat J., et al.: "Inflammatory carcinoma of the uterine cervix. Review of 9 cases". J. Gynecol. Obstet. Biol. Reprod., Paris 1990, 19 (2), 187.

[14] Brown J. V., Fu Y. S., Berek J.S.: "Ovarian metastases are rare in Stage I adenocarcinoma of the cervix". Obstet. Gynecol., 1990, 76, 623.

[15] Burghardt E., Girandi F., Lahousen M., et al.: "Micromvas1ve carcinoma of the uterine cervix (FIGO stage Ia)". Cancer, 1991, 67, 1037.

[16] Kilgore L. C., Soong S. J., Gore H., et al.: "Analysis of prognostic features in adenocarcinoma of the cervix". Gynecol. Oneal., 1988, 31, 137.

[17] Pedersen D., Sogaard H., Overgaard J., Bentzen S. M.: "Prognostic value of pretreatment factors in patients with locally advanced carcinoma of the uterine cervix treated by radiotherapy alone" Acta Oncol., 1995, 34, 787.

[18] Burghardt E., Pickel H.,H aas J.: "Prognostische Faktoren und operative Behandlung des Zervixkarzinoms". In: Burghardt E. (ed.): "Spezielle Gynacologie und Geburtshilfe mit Andrologie und Neonatologie". Vienna, Springer, 1985, 72.

[19] Monaghan J.M., Ireland D.,M or-Yosef S., et al.: "Role of centralization of surgery in stage lb carcinoma of the cervix: a review of 498 cases". Gynecol. Oneal., 1990, 37, 206.

[20] Reddy E. K.,M ansfield C. M.,H artman G. V.,M asterson B. J.: "Carcinoma of the uterine cervix: Review of experience at University of Kansas Medical Center". Cancer, 1981, 47, 1916.

[21] Kovalic J. J., Perez C. A., Grigsby P. W., Lockett M. A.: "The effect of volume of disease in patients with carcinoma of the uterine cervix". Int. J. Oneal. Biol. Phys.,1991, 20, 933.