Introduction/Background Tumor-size is an important factor in the managing of early cervical cancer (early-CC). We aimed to evaluate the correlation between the predicted preoperative tumor size and the histologic tumor size and to examine the impact of tumor size on survival.
Methodology Data on early-CC was retrieved from the Danish Gynecologic Cancer Database (DGCD) and validated against patient files early-CC patients (N=479) treated by radical trachelectomy (n=182) or radical hysterectomy (n=297) at University Hospital Copenhagen 2005–2018. Categorical variables were evaluated by Chi-Square test. Survival estimates were evaluated using in Kaplan Meier or Cox regression analyses.
Results Among patients treated by radical trachelectomy or hysterectomy 91.4% and 73.4% of tumors were correctly predicted to ≤2 cm, while 50% and 75.5% of tumors were correctly categorized to >2 cm preoperatively as compared to the finale pathological examination (table 1).
In univariate analysis the cancer specific survival differed significantly according to predicted as well as histologic tumor size p-value=0.03 and p=0.0001, respectively. In adjusted Cox analysis histologic tumor size (size ≤2 cm vs. >2 cm) was associated with a decrease in the cancer specific survival (HR=5.67; 95% CI: 1,78–18.09). No significant association was found with preoperative predicted tumor size and cancer specific survival.
Conclusion In patient with trachelectomy tumor size ≤2 cm mainly based on cone biopsies are successfully predicted in 91.4% Whereas the prediction of tumor size in patients referred to radical hysterectomy ≤2 cm or >2 is less precise: 73.4% and 75.5%, respectively. Increasing histologic tumor size was associated with a decrease in cancer specific survival.
Imaging like MR-scans may improve the preoperative prediction of tumor size in patients referred to radical hysterectomy and thus, the handling and treatment of early-CC.
Disclosure Nothing to disclose.
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