[1100] Radial Margins Status Impact in Squamous Cervical Cancer Recurrence: A Considerable Prognostic Factor

Rita Canas Marques, Pedro Simoes, Isabel Santana, Antonio Gomes, Ana Francisca Jorge, Ana Felix. Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal; Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal

Background: Cervical carcinoma is the third most common tumor in females and "early stage" disease is predominantly treated by surgery.
Morphological parameters are known to be associated with prognosis. Our aim was to study radial margin status in patients(pts) with cervical cancer treated by radical hysterectomy (RH).
Design: We evaluated cervical carcinomas treated by RH at our institution between 2002-2008. From the 251 cases reviewed, we retrieved all squamous cell carcinomas (SCC) and excluded 152 cases—with previous ablative cone biopsy(119); other histological type(30) and other primary location(3).
The following clinicopathological parameters were evaluated: tumor size(TS), lymph node metastases(LNM), vascular invasion(VI), thickness of invasion of cervical wall(ICW), distance to radial(RM) and vaginal(VM) margins and follow-up(FU) data. Statistical analysis was done using Fisher exact test.
Results: 99 cases with SCC were evaluated. The FU period average was 45months(1-109). At the end of FU 81pts were alive without disease; disease recurrence (DR) occurred in 10pts having 5 died of disease and 5 alive with disease. The remaining pts were lost for FU(6) or died of other cause(2). The results of the clinicopathological parameters are presented in table 1.

Clinicopathological parameters
Parameterswith DRwithout DRp value
TS≤40mm683 
(n=99)>40mm460.0085
LNM+ve621 
(n=99)-ve4680.0233
VI+ve752 
(n=99)-ve337n sign
ICW≤66%129 
(n=90)*>66%753n sign
RM≤1mm726 
(n=99)>1mm3630.0146
VM≤10mm315 
(n=99)>10mm774n sign
* not available in exophytic tumors; +ve: positive; -ve: negative n sign - not significant

DR was statistically correlated with TS>4cm(p=0.008), LNM(p=0.023) and RM≤1mm(p=0.014). No correlation was found regarding VI, ICW and VM and disease recurrence. TS and LNM were not statistically associated between themselves but RM was significantly correlated with TS(p=0.014), LNM(p=0.007) and ICW(p=0.0001). VI was associated with the presence of LNM and deep ICW (p=0.0009 and p=0.0001, respectively).
Conclusions: In our series of cervical SCC, the tumor size, lymph node metastases and distance to radial margin were significantly associated with disease recurrence.
Distance to radial margin is a useful marker of disease recurrence in radical hysterectomies, however this parameter was significantly associated with TS and LN status.
Category: Gynecologic & Obstetrics

Wednesday, March 21, 2012 9:30 AM

Poster Session V # 131, Wednesday Morning

 

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