Occult invasive cervical cancer after simple hysterectomy: a multi-center retrospective study of 89 cases

摘要

Background Occult invasive cervical cancer (OICC) is sometimes incidentally found in surgical specimens after a simple hysterectomy (SH). This study was aimed at identifying a subset of patients with OICC who have a favorable prognosis. This patient group may not require adjuvant radiotherapy and other procedures. Methods The medical records of women in whom OICC was detected after an inadvertent SH were retrospectively reviewed. The relevant data, including clinicopathological characteristics, treatment and clinical outcome were evaluated. The primary and secondary endpoints were overall survival (OS) and relapse-free survival (RFS), respectively. Results Eighty-nine patients who met the inclusion criteria were included for analysis, and the risk of OICC was found to be 1.9?%. Finding an invasive cancer in a hysterectomy specimen after a conization procedure that shows positive margins was the most common reason (41.6?%) for the performance of inadvertent SH. In the univariate analysis, a tumor width?>?20?mm, deep stromal invasion, and lymph node metastasis (LNM) were adversely associated with relapse ( P ?20?mm and deep stromal invasion in the radiotherapy or chemotherapy subgroup ( P Conclusions Simple observation after a lymphadenectomy procedure may be feasible in OICC patients with a tumor width?≤?20?mm, superficial stromal invasion, a negative section margin in hysterectomy specimens, and no LNM.