Analysis of prognostic factors for 5 year survival in surgically treated patients with carcinoma cervix stages IB1, IB2 and IIA

Aim: To identify pathological and clinical prognostic factors that best predict 5 year survival among patients with early stage cervical carcinoma treated with radical hysterectomy. Methods: Data from 77 patients diagnosed at Safdarjung Hospital, New Delhi, India with carcinoma cervix were taken from 1997 to 2002. Patients were followed up for 5 years. Survival probability was calculated through Kaplan–Meier method for overall survival at 5 years. Univariate and multivariate analysis with Cox's regression model was used to statistically identify the best combination of these risk factors to predict prognosis. Results: Univariate analysis revealed tumour size, lymph node involvement and parametrial spread as significant prognostic factors for survival. Multivariate analysis showed that lymph node involvement and parametrial spread remained significant prognostic factors. Overall carcinoma with tumour size of less than 4 cms had a higher chance for survival. Conclusion: The presence of lymph node involvement and parametrial spread decreased the chance of survival by two and a half and threefold, respectively. Lack of awareness about the screening, symptoms of disease and non‐availability of early diagnostic facilities such as the Pap smear at a primary health care level are areas of priority. The most pressing need is to spread awareness among sexually active women to undergo Pap tests at regular intervals.