Morice P, Haie-Meder C, Lhommé C
Services de chirurgie de curiethérapie et de gynécologie médicale Institut Gustave-Roussy 39, rue Camille-Desmoulins 94805 Villejuif.
Rev Prat. 2001 Sep 1;51(13):1432-8.
Tumour stage, tumour size and nodal status are the most important prognostic factors in cervical cancer. Treatment of invasive cervical carcinoma consists of radio-surgical combination, exclusive radiation therapy or exclusive surgery in favourable cases. Radical hysterectomy with lymphadenectomy (pelvic +/- para-aortic) is the reference technical surgery in stage IB and II cervical carcinoma. Conservative surgery can be discussed in young patients with stage IB1 disease. Radiotherapeutic treatment is based on a combination of external irradiation and brachytherapy, with concomitant chemotherapy when bad prognostic factors are present. This treatment represents the reference treatment in advanced stages. Total dose, overall treatment time are important prognostic factors of survival and local control. Pelvic exenteration with reconstructive surgery could be discussed in young patients with centro-pelvic recurrence of a cervical carcinoma.
肿瘤分期、肿瘤大小和淋巴结状态是宫颈癌最重要的预后因素。浸润性宫颈癌的治疗包括放射手术联合治疗、单纯放射治疗或在合适病例中进行单纯手术。根治性子宫切除术加淋巴结清扫术（盆腔±腹主动脉旁）是IB期和II期宫颈癌的标准手术方式。对于IB1期疾病的年轻患者可考虑保守手术。放射治疗基于外照射和近距离放疗相结合，存在不良预后因素时同时进行化疗。这种治疗是晚期患者的标准治疗方法。总剂量、总治疗时间是生存和局部控制的重要预后因素。对于宫颈癌中心性盆腔复发的年轻患者可考虑行盆腔脏器切除术加重建手术。
