What are the determinants of parametrial invasion in patients with early stage cervical cancer: a cross sectional study

Hoorshad, Niloufar; Zamani, Narges; Hasani, Shahrzad Sheikh; Poopak, Amirhossein; Sharifi, Amirsina

What are the determinants of parametrial invasion in patients with early stage cervical cancer: a cross sectional study

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Authors

Hoorshad, Niloufar

Zamani, Narges

Hasani, Shahrzad Sheikh

Poopak, Amirhossein

Sharifi, Amirsina

Issue Date

2022-06-20

Type

Article

Language

en_US

Keywords

Cervical Cancer , Early-Stage , Parametrial Invasion , Less Invasive Surgery

Abstract

Introduction: There was an increase in number of patients presented with early-stage cervical cancer (CC). Tumors with favorable pathological features might be candidates for less radical surgery. Methods: We retrospectively reviewed 700 patients with histologically confirmed CC between January 2011 and March 2020. Chi-square, Fisher's exact tests and multivariate logistic regression analysis were used to assess relations between parametrial involvement (PI) and clinic-pathological variables. Results: Total number of 132 patients with stage IA to IIA were eligible to participate. Squamous cell carcinoma was reported in 100 (75.8%) patients, adenocarcinoma and other tumor pathologies were found in 24(18.2%) and 8(6.1%), respectively. Considering the 2018 FIGO stage, 11 (8.4%) patients had IA, 111 (83%%) IB and 10 (7.6%) IIA. Nine patients (6.8%) had PI on permanent pathologic report. Univariate analysis demonstrated that following variables were statistically different between patients with and without PI: age ≥50, tumor size ≥ 3 cm, lower segment involvement, poorly differentiated pathology, deep stromal invasion, pelvic lymph node, lympho-vascular involvement and positive surgical margin (all p values < 0.05). Among these variables only tumor size ≥3 cm (OR: 2.1, 95% CI: 1.11–4.16, p value: 0.02), deep stromal invasion (OR: 2.2, 95% CI: 1.9–7.43, p value: 0.02) and positive surgical margin (OR: 5.1, 95% CI: 3.97–11.15, p value: 0.008) were independent risk factor of PI in multivariate analysis. Conclusions: Early stage CC might be surgically approached in a more conservative manner if patients have tumor size <3 cm and do not have deep stromal invasion in conization.

Citation

Hoorshad, N., Zamani, N., Sheikh Hasani, S., Poopak, A., & Sharifi, A. (2022). What are the determinants of parametrial invasion in patients with early stage cervical cancer: A cross sectional study. Annals of medicine and surgery (2012), 79, 104020. https://doi.org/10.1016/j.amsu.2022.104020

Publisher

Annals of Medicine and Surgery