Irie T, Kigawa J, Minagawa Y, Itamochi H, Sato S, Akeshima R, Terakawa N
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
Eur J Surg Oncol. 2000 Aug;26(5):464-7. doi: 10.1053/ejso.1999.0923.
The aim of the present study was to evaluate the outcome of patients with stage lb-IIb cervical adenocarcinoma treated with radical hysterectomy, and to determine the clinicopathological characteristics of those patients.
A total of 255 patients with cervical carcinoma stage Ib-IIb (57 adenocarcinoma and 198 squamous cell carcinoma) who had undergone radical hysterectomy were included in this study. Patient survival distribution was calculated using the Kaplan-Meier method.
The estimated 5-year survival rate for patients with adenocarcinoma was significantly poorer than that for patients with squamous cell carcinoma (77.9% vs 91.7%). The survival rate in stage Ib patients did not differ between two groups (95.8% vs 94.4% respectively). The incidence of lymph node involvement was significantly higher in patients with adenocarcinoma than in those with squamous cell carcinoma (31.6% vs 14.8%). Among patients receiving post-operative radiotherapy, the survival rate for adenocarcinoma (71.1%) was significantly poorer than that for squamous cell carcinoma (90.0%). When patients underwent radical hysterectomy, the survival rate for stage II patients with adenocarcinoma was significantly poorer than that for patients with squamous cell carcinoma.
The higher incidence of lymph node involvement and lower response to post-operative radiotherapy are considered to be factors of poorer prognosis in cervical adenocarcinoma.
本研究旨在评估接受根治性子宫切除术的Ib-IIb期宫颈腺癌患者的治疗结果,并确定这些患者的临床病理特征。
本研究纳入了255例接受根治性子宫切除术的Ib-IIb期宫颈癌患者(57例腺癌和198例鳞状细胞癌)。采用Kaplan-Meier法计算患者生存分布。
腺癌患者的估计5年生存率显著低于鳞状细胞癌患者(77.9%对91.7%)。Ib期患者的生存率在两组之间无差异(分别为95.8%对94.4%)。腺癌患者的淋巴结受累发生率显著高于鳞状细胞癌患者(31.6%对14.8%)。在接受术后放疗的患者中,腺癌患者的生存率(71.1%)显著低于鳞状细胞癌患者(90.0%)。当患者接受根治性子宫切除术时,II期腺癌患者的生存率显著低于鳞状细胞癌患者。
淋巴结受累发生率较高以及对术后放疗反应较低被认为是宫颈腺癌预后较差的因素。