Use of preoperative clinicopathologic characteristics to identify patients with low-risk cervical cancer suitable for Piver class II radical hysterectomy

Abstract

Objective: To investigate the long-term efficacy of Piver-Rutledge class II radical hysterectomy (Piver II RH) for treatment of early-stage cervical cancer and to identify suitable candidates for this procedure.

Methods: A retrospective study was conducted of 432 cervical cancer patients (tumor size ≤4 cm) treated with Piver II RH at Sun Yat-sen University Cancer Center, Guangzhou, China, between January 1, 1999, and June 30, 2005. The correlation of preoperative and postoperative characteristics with recurrence and survival was analyzed.

Results: Median follow-up was 72 months; the overall recurrence rate was 14.6%. The 5-year recurrence-free survival (RFS) was 88.0% and the 5-year overall survival (OS) was 93.0%. Significant differences were observed between patients with small (≤2 cm) and large (>2 cm) tumors with regard to intra-pelvic recurrence (2.5% vs 13.4%; P=0.001), extra-pelvic recurrence (3.4% vs 9.9%; P=0.028), RFS (95.0% vs 86.0%; P=0.005), and OS (95.0% vs 87.0%; P=0.005). Preoperative tumor size was the only factor that correlated with recurrence (P=0.018), RFS (P=0.038), and OS (P=0.029) in a multivariate analysis.

Conclusion: Cervical cancer patients with tumors of 2 cm or less were identified as candidates for Piver II RH, which promoted excellent local tumor control and long-term survival.