Ayhan A, Al R A, Baykal C, Demirtas E, Ayhan A, Yüce K
Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hacettepe University School of Medicine, Hacettepe University Hospitals, 06100 Sihhiye, Ankara, Turkey.
Int J Gynecol Cancer. 2004 Mar-Apr;14(2):286-92. doi: 10.1111/j.1048-891X.2004.014212.x.
The aim of this study was to evaluate the clinical and pathologic prognostic variables for disease free survival, overall survival and the role of adjuvant radiotherapy in FIGO stage IB cervical carcinoma without lymph node metastasis.
A retrospective review was performed of 393 patients with lymph node negative stage IB cervical cancer treated by type 3 hysterectomy and pelvic lymphadenectomy at the Hacettepe University Hospitals between 1980 and 1997.
The disease free survival and overall survival were 87.6 and 91.0%, respectively. In univariate analysis, tumor size, depth of invasion, vaginal involvement, lympho-vascular space involvement (LVSI) and adjuvant radiotherapy were found significant in disease free survival. Overall survival was affected by tumor size, LVSI, vaginal involvement and adjuvant radiotherapy. Tumor size, LVSI and vaginal involvement were found as independent prognostic factors for overall and disease free survival in multivariate analysis. Disease free survival, recurrence rate and site did not differ between patients underwent radical surgery and radical surgery plus radiotherapy.
Tumor size, LVSI and vaginal involvement were independent prognostic factors in lymph node negative FIGO stage IB cervical cancer. Adjuvant radiotherapy in stage IB cervical cancer patients with negative nodes provides no survival advantage or better local tumoral control.
本研究旨在评估无淋巴结转移的国际妇产科联盟(FIGO)IB期宫颈癌患者无病生存期、总生存期的临床和病理预后变量,以及辅助放疗的作用。
对1980年至1997年间在哈杰泰佩大学医院接受Ⅲ型子宫切除术和盆腔淋巴结清扫术治疗的393例淋巴结阴性的IB期宫颈癌患者进行回顾性研究。
无病生存率和总生存率分别为87.6%和91.0%。单因素分析显示,肿瘤大小、浸润深度、阴道受累情况、淋巴血管间隙受累(LVSI)和辅助放疗在无病生存方面具有显著意义。总生存期受肿瘤大小、LVSI、阴道受累情况和辅助放疗的影响。多因素分析发现,肿瘤大小、LVSI和阴道受累情况是总生存期和无病生存期的独立预后因素。接受根治性手术的患者与接受根治性手术加放疗的患者在无病生存期、复发率和复发部位方面无差异。
肿瘤大小、LVSI和阴道受累情况是淋巴结阴性的FIGO IB期宫颈癌的独立预后因素。IB期淋巴结阴性的宫颈癌患者接受辅助放疗并不能带来生存优势或更好的局部肿瘤控制。