493例Ⅰ-ⅡA期宫颈癌根治术后残端复发相关因素分析

doi:10.3760/cma.j.issn.1004-4221.2019.05.007

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract

Objective To explore the prognostic factors for the recurrence of vaginal stump of early-stage cervical cancer after radical hysterectomy and evaluate the effect on clinical prognosis.Methods Clinical data of stage Ⅰ-ⅡA cervical cancer patients undergoing radical hysterectomy in Guizhou Cancer Hospital from January, 2007 to December, 2016 were retrospectively analyzed.Results A total of 493 patients were enrolled and followed up until May 30, 2018.Among them, 96.6%(474/493) completed the follow-up.The median age was 45 years. Patients aged 40-50 years had a high incidence rate.In total, 451 cases (91.48%) had no recurrence of vaginal stump. The average time without stump recurrence was 51.2 months and the median time without stump recurrence was 44.8 months. MultivariateCox regressionanalysis demonstrated that pelvic external irradiation and brachytherapy were the independent prognostic factors for the recurrence of vaginal stump (P=0.000,0.000).Tumor size, lymph node metastasis and pelvic external irradiation were the independent prognostic factors for overall survival (P=0.045,0.022,0.000).Conclusions Pelvic external irradiation and brachytherapy play an extremely pivotal role in reducing the risk of vaginal stump recurrence after radical hysterectomy for patients with stage Ⅰ-Ⅱ A cervical cancer. Tumor size, lymph node metastasis and pelvic external irradiation are the independent prognostic factors for overall survival of patients with stage Ⅰ-ⅡA cervical cancer following radical hysterectomy.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Liu Guangrong
	Ran Li
	Ji Wei
	Yu Miao
	Chang Jianying
	Li Fenghu
	Li Jiehui

Key words： Cervical neoplasms/surgery Radical operation Vaginal stump recurrence Cervical neoplasms/external pelvic irradiation Cervical neoplasms/brachytherapy

Corresponding Authors: Ran Li,Email:ranli171@hotmail.com

Cite this article:

Liu Guangrong,Ran Li,Ji Wei et al. Analysis of prognostic factors for recurrence of vaginal stump in 493 cases of stage Ⅰ-ⅡA cervical cancer after radical hysterectomy[J]. Chinese Journal of Radiation Oncology, 2019, 28(5): 353-357.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2019.05.007 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2019/V28/I5/353

[1]Ginsburg O,Bray F,Coleman MP,et al. The global burden of women′s cancers:a grand challenge in global health[J].Lancet,2017,389(10071):847-860.DOI:10.1016/S0140-6736(16)31392-7.
[2]Chen W,Zheng R,Baade PD,et al. Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.DOI:10.3322/caac.21338.
[3]周晅.放化疗同步治疗晚期或复发性宫颈癌临床分析[J].中外医学研究,2015,13(11):43-44.DOI:10.14033/j.cnki.cfmr.2015.11.019.
Zhou H.Clinical analysis of concurrent radiotherapy and chemotherapy for advanced or recurrent cervical cancer[J].Chin Fore Med Res,2015,13(11):43-44.DOI:10.14033/j.cnki.cfmr.2015.11.019.
[4]李秀芳.宫颈癌术后复发的高危因素及不同治疗方法对其预后的影响探析[J].实用妇科内分泌杂志(电子版),2016,3(16):137-138.
Li XF.High-risk factors for recurrence of cervical cancer after operation and the influence of different[J].J Pract Gynecol Endocrinol,2016,3(16):137-138.
[5]Kasamatsu T, Onda T, Yamada T, et al. Clinical aspects and prognosis of pelvic recurrence of cervical carcinoma[J].Int J Gynaecol Obstet, 2005,89(1):39-44.DOI:10.1016/j.ijgo.2004.12.020.
[6]杨凌云,王红静,贾西彪,等.1543例子宫颈癌临床病理特征分析[J].四川大学学报(医学版),2011,42(6):882-884.DOI:10.13464/j.scuxbyxb.2011.06.022.
Yang LY,Wang HJ,Jia XB,et al. Analysis of clinicopathological features of 1543 cases of cervical cancer[J].J Sichuan Univ (Med Sci Ed),2011,42(6):882-884.DOI:10.13464/j.scuxbyxb.2011.06.022.
[7]Marchiolé P,Buénerd A,Benchaib M,Nezhat K,Dargent D,Mathevet P.Clinical significance of lympho vascular space involvement and lymph node micrometastases in early-stage cervical cancer:a retrospective case-control surgico-pathological study. Gynecol Oncol,2005,97(3):727-732.DOI:10.1016/j.ygyno.2005.01.004.
[8]李丹青,曲怡,徐晓颖,等.宫颈癌根治术后阴道残端复发的相关因素分析[J].医学信息,2015(32):28-29.
Li DQ,Qu Y,Xu XY,et al. Influential factors for recurrent cervical cancer of vaginal stump following radical hysterectomy[J].Med Informat,2015(32):28-29.
[9]王登凤,石宇,张国楠,等.393例ⅠB1~ⅡA2期子宫颈癌患者的临床病理与预后分析[J].肿瘤预防与治疗,2017,30(4):254-260.DOI:10.3969/j.issn.1674-0904.2017.04.003.
Wang DF,Shi Y,Zhang GN,et al. The clinical and prognostic analysis of 363 cases of Stage ⅠB1-ⅡA2 cervical cancer[J].J Cancer Cont Treat,2017,30(4):254-260.DOI:10.3969/j.issn.1674-0904.2017.04.003.
[10]庄晴晴,王常玉.新辅助化疗与单纯手术在局部晚期宫颈癌患者中的疗效对比分析[J].现代妇产科进展,2016,25(07):487-490.DOI:10.13283/j.cnki.xdfckjz.2016.07.002.
Zhuang QQ,Wang CY.Comparative analysis of neoadjuvant chemotherapy plus surgery versus surgery in local advanced cervical cancer[J].Prog Obstet Gynecol,2016,25(07):487-490.DOI:10.13283/j.cnki.xdfckjz.2016.07.002.
[11]Rotman M,Sedlis A,Piedmonte MR,et al. A phase Ⅲ randomized trial of postoperative pelvic irradiation in Stage ⅠB cervical carcinoma with poor prognostic features:follow-up of a gynecologic oncology group study[J].Int J Radiat Oncol Biol Phys,2006,65(1):169-176.DOI:10.1016/j.ijrobp.2005.10.019.DOI:10.1016/j.ijrobp.2005.10.019.
[12]Stehman FB,Bundy BN,DiSaia PJ,et al. Carcinoma of the cervix treated with radiation therapy. I.A multi-variate analysis of prognostic variables in the gynecologic oncology group[J].Cancer,1991,67(11):2776-2785.
[13]Sedlis A,Bundy BN,Rotman MZ,et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage ⅠB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy:a gynecologic oncology group study[J].Gynecol Oncol,1999,73(2):177-183.DOI:10.1006/gyno.1999.5387.
[14]Metindir J,Bilir G.Prognostic factors affecting disease-free survival in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic-paraaortic lymphadenectomy[J].Eur J Gynaecol Oncol,2007,28(1):28-32.DOI:10.1016/j.earlhumdev.2006.05.007.
[15]Tuipae S,Yanaranop M,Oniem N.Role of adjuvant radiotherapy after radical hysterectomy in node-negative stage ⅠB-ⅡA cervical cancer with intermediate risk factors[J].J Med Assoc Thai,2012,95(Suppl 3):S117-124.