Van de Putte Gregg, Lie A Kathrine, Vach Werner, Baekelandt Mark, Kristensen Gunnar B
Department of Gynecologic Oncology, The Norwegian Radium Hospital, Montebello, 0310 Oslo, Norway.
Gynecol Oncol. 2005 Oct;99(1):106-12. doi: 10.1016/j.ygyno.2005.05.026.
To test the Gynecologic Oncology Group (GOG) prognostic criteria (based on stromal invasion, tumor size and vascular invasion) for early squamous cervical carcinoma (SCC) in an independent population and to evaluate the prognostic value of a simpler model.
We studied 221 patients who underwent radical hysterectomy and bilateral lymphadenectomy for stage IB SCC between 1987 and 1993. Adjuvant treatment consisting of radiotherapy and/or chemotherapy was given in case of large tumor size, positive lymph nodes or invasion into the parametria. Histological slides from all patients were reviewed by one pathologist.
The GOG criteria divided the patients from our population in a small low risk group (3-year relapse-free rate (RFR) of 100%), a small high risk group (RFR of 57%) and a bigger intermediate risk group (RFR of 80-90%). These results are in good agreement with those of the original publication. A risk model based on 2 of the 3 factors used by the GOG may perform as well as the 3-factor model, especially when allowing interaction. Tumors measuring >2 cm and invading into the outer third of the cervical wall had a 5-year DFS of 56% compared to 93% for tumors measuring < or =2 cm or invading to less then the outer third of the cervical wall.
The GOG criteria could be validated in this independent population. A model based on 2 of the 3 factors may perform as good.
在一个独立人群中检验妇科肿瘤学组（GOG）针对早期宫颈鳞状细胞癌（SCC）的预后标准（基于间质浸润、肿瘤大小和血管浸润），并评估一个更简单模型的预后价值。
我们研究了1987年至1993年间因IB期SCC接受根治性子宫切除术和双侧淋巴结清扫术的221例患者。对于肿瘤体积大、淋巴结阳性或侵犯子宫旁组织的患者，给予放疗和/或化疗的辅助治疗。所有患者的组织学切片由一名病理学家复查。
GOG标准将我们人群中的患者分为一个小的低风险组（3年无复发生存率（RFR）为100%）、一个小的高风险组（RFR为57%）和一个较大的中度风险组（RFR为80 - 90%）。这些结果与原始出版物的结果高度一致。基于GOG使用的3个因素中的2个的风险模型可能与3因素模型表现一样好，特别是在允许相互作用的情况下。直径>2 cm且侵犯宫颈壁外三分之一的肿瘤5年无病生存率（DFS）为56%，而直径≤2 cm或侵犯宫颈壁不到外三分之一的肿瘤为93%。
GOG标准可在这个独立人群中得到验证。基于3个因素中的2个的模型可能表现同样良好。
