Multivariate analysis of the morphometric characteristics of tumours as prognostic factors in the survival of patients with uterine cervix cancer treated with radical surgery.

OBJECTIVES: To analyse the influence of tumour size and anatomopathological characteristics in the prognosis of patients with early-stage cancer of the uterine cervix treated with radical surgery. STUDY DESIGN: A historical study of 114 patients treated at the Maternity Hospital "La Fe" in Valencia was undertaken during the period 1971-1989. The influence of the principal risk factors on prognosis were studied and their effect adjusted using a multivariate analysis based on the Cox proportional hazards model. RESULTS: A greater dimension of the tumour, tumour area, tumour volume, tumour-cervix quotient and stromal invasion depth all have a highly significant and negative correlation with survival and disease-free survival intervals. In the multivariate analysis, tumour volume and stromal invasion depth maintained their significance as indicators of an adverse prognosis regarding the disease-free survival interval, as did the stromal invasion depth in the case of survival. CONCLUSIONS: The most important prognostic factor in the evolution of patients with a cervical carcinoma is the stromal invasion depth followed by tumour size.

The prognostic implications of anaemia in the outcome of patients with early stages of uterine cervix carcinoma.

We studied the prognostic value of anaemia in the evolution of patients with early stages of uterine cervix cancer and treated with radical surgery. An observational study of 114 patients treated for cervical cancer at the "La Fe" Maternity Hospital in Valencia (Spain) during the period 1971 to 1989. Survival analyses were carried out whereby both recurrence and mortality rates were considered. The level of haemoglobin influences the prognosis of the patients in the study presented, and explains a variation in the disease-free interval in correlation with that of tumour size. However, its influence on the survival interval proved to be somewhat less. Its predictive value is not diminished when associated with other important factors regarding the influence on patient evolution and is seen to be a protector variable against recurrence. Patients with haemoglobin levels of less than 13 gr/dl have a less favourable prognosis and this prognosis worsens still further when levels are lower than 12 gr/dl, which is more frequently the case in patients under 40 years of age and with a greater stromal invasion depth. The influence of haemoglobin levels is equally as important in its influence on prognosis and patient evolution as the volume of the tumour itself. The effect of this variable depends on both the clinical characteristics of the patients and the pathological characteristics of the tumour.