Abstract

Objectives: In light of studies suggesting that tumor size is a prognostic factor for Stage IIA cervical cancers, FIGO revised the cervical cancer staging criteria, subdividing Stage IIA into Stages IIA1 and IIA2, based on tumor size (<= 4 cm and >4cm). This study aims to determine if the new sub-staging has any impact on overall survival as well as elucidate any other prognostic factors and treatment patterns in this category of patients.
Materials and Methods: This is a case series of women diagnosed with Stage IIA cervical cancer in KK Women's & Children's Hospital between 2001 and 2005. Statistical analysis was performed with SPSS version 19.
Results: A total of 66 patients were diagnosed with Stage IIA cervical cancer between 2001 and 2005. Of the 50 patients which met the inclusion criteria, 35 (70%) had stage IIA1 and 15 (30%) had Stage IIA2 cervical cancer. The overall 5 year survival was not significantly different between Stage IIA1 and IIA2 (79.6% vs 73.3%, p=0.9). Likewise, progression free survival was not significantly different between Stage IIA1 and IIA2 (76% vs 80%, p=0.86). Patients who underwent radical hysterectomy performed better than those treated by primary radiotherapy (87% vs 69.6%, p=0.043). Cox regression analysis showed that age, tumor grade, histology types, tumor size and lymph node status were not independent predictors of survival.
Conclusion: Our preliminary results did not find any difference in overall survival based on the new FIGO sub-staging of IIA1 and IIA2. Larger studies are needed to confirm this finding.