Clinicopathological features and prognostic factors for survival and lymph node metastases in stage IB adenocarcinoma of the cervix

Purpose: To compare the clinicopathological characteristics of patients with stage IB adenocarcinoma (AC) of the cervix and to determine the risk factors for survival and lymph node metastasis. Methods: We retrospectively analyzed 83 patients with stage IB cervical AC treated between 2011 and 2018. The Silva Classification was used to classify all specimens. Kaplan-Meier method was used for survival analysis and Cox regression model used for univariate and multivariate analysis of prognostic factors for survival. A binary logistic regression model was used for the univariate and multivariable analysis of the risk factors for lymph node metastasis. Results: The median follow-up was 45 months (range from 9 to 95 months). A total of 64 (77.12%) patients had stage IB1 and 19 (22.89%) stage IB2. Six patients had recurrence, out of which, 5 died. Univariate analysis revealed that only LVSI (P = 0.001) was a significant prognostic factor. Multivariate analysis showed that LVSI (P = 0.037) was also the only independent significant prognostic factor. By univariate analysis, grade 3 (P = 0.04), LVSI (P <$<$ 0.001), depth of stromal invasion ≥$\ge$10 mm (P = 0.049), Silva C (P <$<$ 0.001) were significant risk factors for lymph node metastasis. Multivariate analysis showed that LVSI (P = 0.03) and Silva C (P = 0.023) were the independent risk factors for lymph node metastasis. Conclusions: For stage IB AC, LVSI was the only independent prognostic factor for survival. LVSI and Silva C were the independent risk factors for lymph node metastasis.

Prognostic factor; Adenocarcinoma of the uterine cervix; Lymph node metasta- sis; Silva classification

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