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Risk factors for parametrial invasion in early-stage cervical cancer: Toward less radical surgery.

作者信息

Güler Çekiç Sebile, Bulut Mehmet, Aldıkaçtıoğlu Talmaç Merve, Aydın Emine, Büyükkaya Öcal Emine Ufuk, Akça Aysu, Numanoğlu Ceyhun, Ülker Volkan, Akbayır Özgür

机构信息

Koç University Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Türkiye.

Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Türkiye.

出版信息

Turk J Obstet Gynecol. 2025 Sep 5;22(3):237-245. doi: 10.4274/tjod.galenos.2025.39969.


DOI:10.4274/tjod.galenos.2025.39969
PMID:40908724
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12411973/
Abstract

OBJECTIVE: Radical hysterectomy with parametrectomy remains the standard treatment for early-stage cervical cancer but is associated with significant morbidity. Identifying patients at low risk for parametrial invasion is critical to support less invasive surgical strategies. MATERIALS AND METHODS: This retrospective study evaluated 177 patients with Federation of Gynecology and Obstetrics 2018 stage IA-IIB cervical cancer who underwent type III radical hysterectomy with lymphadenectomy between 2001 and 2020. Clinical and pathological data were analyzed to identify predictors of parametrial invasion. RESULTS: Parametrial invasion was observed in 40 patients (22.6%). These patients were significantly older (mean age 56.05±11.16 vs. 49.21±10.80 years, p=0.013), and they were more likely to be postmenopausal. Parametrial invasion was associated with larger tumor size (35.10±13.72 mm vs. 24.15±13.50 mm), greater depth of stromal invasion (>10 mm), lymphovascular space invasion (LVSI), and lymph node metastases, (pelvic and paraaortic), all p<0.01. Bivariate logistic regression identified age ≥55 years [odds ratio (OR): 3.302 95% confidence interval (CI): 1.432-7.614, p=0.005], LVSI positivity [OR: 3.952 (95% CI: 1.641-9.518, p=0.002], and stromal invasion depth >10 mm [OR: 5.326 (95% CI: 2.157-13.153, p<0.001] as independent predictors of parametrial invasion. CONCLUSION: Age ≥55, LVSI, and deep stromal invasion are significant independent risk factors for parametrial invasion. Careful evaluation of these parameters may guide the selection of patients suitable for less radical surgery, potentially reducing morbidity without compromising oncologic outcomes.

摘要

相似文献

[1]
Risk factors for parametrial invasion in early-stage cervical cancer: Toward less radical surgery.

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[2]
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[4]
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[6]
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本文引用的文献

[1]
A novel predictive model of lymphovascular space invasion in early-stage endometrial cancer.

Turk J Obstet Gynecol. 2024-3-4

[2]
Simple versus Radical Hysterectomy in Women with Low-Risk Cervical Cancer.

N Engl J Med. 2024-2-29

[3]
Discussion on cervical cytology in postmenopausal women.

Minerva Obstet Gynecol. 2024-12

[4]
Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative.

Lancet Glob Health. 2023-2

[5]
Nomogram Predicting Parametrial Involvement Based on the Radical Hysterectomy Specimens in the Early-Stage Cervical Cancer.

Front Surg. 2021-10-27

[6]
The impact of aging on innate and adaptive immunity in the human female genital tract.

Aging Cell. 2021-5

[7]
Less radical surgery for early-stage cervical cancer: a systematic review.

Am J Obstet Gynecol. 2021-4

[8]
Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis.

Lancet Glob Health. 2019-12-4

[9]
Factors predicting parametrial invasion in patients with early-stage cervical carcinomas.

PLoS One. 2018-10-18

[10]
Assessment of Parametrial Involvement in Early Stages Cervical Cancer With Preoperative Magnetic Resonance Imaging.

Int J Gynecol Cancer. 2018-11

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