Lee K Bm, Lee J M, Park C Y, Lee K B, Cho H Y, Ha S Y
Department of Obstetrics and Gynecology, Gachon Medical School Gil Medical Center, Inchon, South Korea.
Int J Gynecol Cancer. 2006 Jul-Aug;16(4):1569-73. doi: 10.1111/j.1525-1438.2006.00628.x.
The objective of this study was to investigate the efficacy of treatment strategies in patients with adenocarcinoma (AC) of the cervix and compare it with those with squamous cell carcinoma (SCC) of the cervix. Women with FIGO (1994) stage IB1 AC, especially pathologic tumor size of 2-4 cm, treated with class III hysterectomy, were compared with those with SCC treated with comparable strategy in a case-controlled study. Eighty patients (20 cases, 60 controls) were analyzed. Lymphvascular space invasion (P = 0.01) and lymph node metastasis (P = 0.07) were more frequent in patients with SCC than in those with AC. However, there was no significant difference in depth of stromal invasion (P = 0.51) and invasion of the parametrium (P = 0.44) between two groups. And there was also no statistically significant difference in disease-free survival (P = 0.86) and overall survival (P = 0.89) between two groups. Primary radical surgery followed by adjuvant therapy, same as for SCC, would be acceptable for AC with pathologic tumor size of 2-4 cm. Although it was difficult to determine whether AC recurred more systemically, more effective treatment strategies than those currently available for AC should be considered to reduce the systemic recurrence.
本研究的目的是调查子宫颈腺癌（AC）患者治疗策略的疗效，并将其与子宫颈鳞状细胞癌（SCC）患者的治疗策略进行比较。在一项病例对照研究中，将采用III类子宫切除术治疗的国际妇产科联盟（1994年）IB1期AC患者，尤其是病理肿瘤大小为2 - 4 cm的患者，与采用类似策略治疗的SCC患者进行比较。对80例患者（20例病例，60例对照）进行了分析。SCC患者的淋巴血管间隙浸润（P = 0.01）和淋巴结转移（P = 0.07）比AC患者更常见。然而，两组之间的间质浸润深度（P = 0.51）和宫旁组织浸润（P = 0.44）没有显著差异。两组之间的无病生存期（P = 0.86）和总生存期（P = 0.89）也没有统计学上的显著差异。对于病理肿瘤大小为2 - 4 cm的AC患者，与SCC患者一样，先进行根治性手术再进行辅助治疗是可以接受的。尽管很难确定AC是否更易发生全身复发，但应考虑采用比目前治疗AC更有效的治疗策略来减少全身复发。
