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Cervical carcinoma: a hazard model in early stage disease
  1. R. J. HALE*,
  2. W. D.J. RYDER,
  3. F. L. WILCOX,
  4. C. H. BUCKLEY* and
  5. V. R. TINDALL§
  1. *Department of Reproductive Pathology
  2. §University Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester
  3. Department of Medical Statistics, Christie Hospital and Holt Radium Institute, Manchester
  4. Department of Obstetrics and Gynaecology, Royal Victoria Hospital, Blackpool
  1. Address for correspondence: R.J. Hale, Department of Histopathology, St Mary's Hospital, Whitworth Park, Manchester M13 OJH, UK.

Abstract

The 235 patients with stage IB/IIA cervical carcinoma treated by Wertheim's hysterectomy, as a primary procedure, at St Mary's Hospital, Manchester between 1975 and 1989 inclusive, form the basis of this study. Using Cox's regression model, four variables were shown to have independent prognostic significance. These were: (1) lymphatic permeation (adjacent to the tumor); (2) tumor volume; (3) being pregnant at diagnosis and (4) lymph node metastases. A heuristic model was formulated which was based upon these four factors and by using this information it was possible to separate the patients into four distinct prognostic groups. It is suggested that this model may prove useful in identifying those patients at a higher risk of dying of disease and who would benefit from early adjuvant systemic therapy.

  • cervical carcinoma
  • heuristic model
  • prognostic factors

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