Ayhan Ali, Otegen Umit, Guven Suleyman, Kucukali Turkan
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey.
J Surg Oncol. 2006 Jul 1;94(1):28-34. doi: 10.1002/jso.20550.
To evaluate the patients with invasive cervical cancer found in simple hysterectomy and who were subjected to radical parametrectomy and upper vaginectomy with therapeutic lymphadenectomy.
Twenty-seven patients who underwent the radical parametrectomy and upper vaginectomy with therapeutic lymphadenectomy procedure from 1986 to 2004 were retrospectively reviewed.
The mean age at the time of diagnosis was 49.85 (range 38-72). The histopathological diagnoses were SCC, adenocarcinoma, adenosquamous carcinoma, endometroid carcinoma, and anaplastic carcinoma in 70.4%, 11.4%, 7.4%, 7.4%, and 3.7% of patients, respectively. Operative complications occurred in only five patients (18.5%). Following radical surgery, residual disease was found in 10 patients (37.03%). The lymph node involvement rate was 22.2% (6 patients). The recurrence rate was 7.4% (2 of 27 patients). The overall disease-free survival rate was 88.67%. The overall survival rate was 88.89%; it was significantly lower in the presence of the following factors: anaplastic carcinoma, vaginal apex metastasis, and pelvic lymph node metastasis.
This series suggests the excellent overall survival of patients that underwent radical surgery. We recommend the surgical treatment of such selected patients in experienced centers only with expert surgeons and primary adjuvant radiotherapy may be recommended in selected patients.
评估在单纯子宫切除术中发现的浸润性宫颈癌患者，这些患者接受了根治性子宫旁组织切除术、上阴道切除术及治疗性淋巴结清扫术。
回顾性分析了1986年至2004年期间接受根治性子宫旁组织切除术、上阴道切除术及治疗性淋巴结清扫术的27例患者。
诊断时的平均年龄为49.85岁（范围38 - 72岁）。组织病理学诊断分别为鳞状细胞癌（SCC）、腺癌、腺鳞癌、子宫内膜样癌和间变性癌的患者比例分别为70.4%、11.4%、7.4%、7.4%和3.7%。仅5例患者（18.5%）发生手术并发症。根治性手术后，10例患者（37.03%）发现残留病灶。淋巴结受累率为22.2%（6例患者）。复发率为7.4%（27例患者中的2例）。总体无病生存率为88.67%。总体生存率为88.89%；在存在以下因素时显著较低：间变性癌、阴道顶端转移和盆腔淋巴结转移。
本系列研究提示接受根治性手术的患者总体生存良好。我们建议仅在有经验的中心由专业外科医生对这类选定患者进行手术治疗，对于选定患者可推荐进行原发辅助放疗。
