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  • Title: [Prognostic impact of tumour volume and lymph node involvement in intermediate stage T1b1 to T2b cancer of the uterine cervix].
    Author: Goudy G, Stoeckle E, Thomas L, Kind M, Guyon F, Brouste V, Floquet A.
    Journal: Bull Cancer; 2009 Jun; 96(6):685-94. PubMed ID: 19467961.
    Abstract:
    OBJECTIVE: Determine the prognostic significance of tumour volume and pelvic lymph node status in intermediate stage T1b1 to T2b cancers of the uterine cervix. PATIENTS AND METHODS: Multivariate prognostic factor study in 219 patients (pts), median age 48 years, with stage T1b1 > 2 cm to T2b cervical cancers treated in 91% by primary radio- +/- chemotherapy. All had a pretherapeutic laparoscopic pelvic lymphadenectomy, and 166 pts. had their tumour volume assessed by MRI. Patient and tumour characteristics were considered for analysis. RESULTS: Significant prognostic variables in univariate analysis were the ASA anaesthetic score, stage T2b, tumour diameter, involvement of the uterine corpus, radiological (N1) and histological (N+) pelvic lymph node involvement and bilateral N+. Tumour volume was not significant. In multivariate analysis stage T2b (HR = 2.5; p = 0.003), N+ (HR = 3; p = 0.003) and bilateral N+ (HR = 6.1; p < 0.0001) were independent prognostic factors. Four prognostic groups according the existence of 0 to 3 prognostic factors showed their overall survivals declining from 97 to 27% (p < 0.0001). CONCLUSION: Stage T2b and pelvic lymph node involvement, but not tumour volume, are the major prognostic factors in intermediate stage cervical cancers. Pelvic lymph node involvement should be determined before treatment.
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