Original researchLymphovascular and perineural invasion in the parametria: a prognostic factor for early-stage cervical cancer
Section snippets
Materials and methods
A total of 93 patients with a diagnosis of early stage (IA2–IIA) cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy with or without paraaortic lymphadenectomy between 1975 and 2001 were identified at three different medical centers: University of California Los Angeles, Oliview-UCLA, and Kaiser Permanente Los Angeles. Patients were considered eligible for this study if they had a diagnosis of early-stage cervical cancer (IA2–IIA) and underwent primary surgery by a
Results
The median age in the study population was 46 years (range, 22–75). Median follow-up time was 33 months (range, 1–250). The study group comprised 93 patients. Of these, 80 patients (86%) had squamous cell carcinoma and 13 (14%) had adenocarcinoma of the cervix. All patients had early-stage cervical cancer (2 IA2, 52 IB1, 31 IB2, and 8 IIA) and underwent a radical hysterectomy and pelvic lymphadenectomy. Paraaortic lymphadenectomy was performed in 54 (58%) patients. Bilateral
Discussion
The significance of parametrial resection in the operative management of patients with cervical cancer has led to the evolution of the surgical techniques used in managing these patients. Simple vaginal hysterectomy was first performed, leading to poor results. In 1893, Schuchardt resected parametrial tissue in addition to the uterus via a vaginal technique and observed a marked improvement in outcome.5 A more extensive parametrial resection and ureteral dissection through an abdominal approach
Acknowledgements
The authors thank Jeffrey Gornbein, DrPH, and Susan Service, MS, of the Department of Biomathematics, David Geffen School of Medicine at UCLA for their assistance with the statistical analysis.
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