Xiong Ying, Liang Li-zhi, Zheng Min, Wang Luan-hong, Deng Peng-fei, Liu Ji-hong
Department of Gynecologic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Jun;43(6):425-8.
To investigate the pattern of disease relapse and prognostic risk factor of patients with cervical carcinoma and pelvic lymph node metastasis.
A total of 124 cases of International Federation of Gynecology and Obstetrics (FIGO) Ib1-IIa cervical carcinoma with pelvic node metastasis who were treated at the Cancer Center of Sun Yat-sen University during January 1994 to December 2001 were selected for this study. Prognosis and recurrence were retrospectively analyzed using the clinico-pathological data
The overall 5 year survival and 5 year disease-free survival were 63.3% and 61.4%, respectively. Overall recurrence rate was 39.5% (49/124), among which intra-pelvic relapse (61.0%, 25/41) was significantly more common than extra-pelvic relapse (31.7%,13/41; P=0.008). Multivariate analysis identified involvement of common iliac node as an independent prognostic factor (P=0.035). According to this factor, node-positive patients could be divided into low risk group (without common iliac node involvement, 104 cases) and high risk group (with common iliac node involvement, 20 cases). The 5 year disease-free survival were 69.4% and 24.5% respectively, with a significant difference (P=0.003). Intra-pelvic relapse was observed in 22.1% (23/104) of low risk and 25.0% (5/20) of high risk group respectively, with no significant difference (P>0.05). However extra-pelvic relapse was seen in 7.7% (8/104) of low risk and 40.0% (8/20) of high risk group, with a significant difference (P<0.01).
Common iliac node involvement is a significant factor influencing the prognosis of patients with cervical carcinoma and pelvic lymph node metastasis. Patients with positive common iliac nodes have significantly decreased 5 year disease-free survival and higher extra-pelvic disease recurrence rates compared with those whose common iliac nodes are negative. These findings provide important data for design of individualized treatment mode.
探讨宫颈癌伴盆腔淋巴结转移患者的疾病复发模式及预后危险因素。
选取1994年1月至2001年12月在中山大学肿瘤防治中心接受治疗的124例国际妇产科联盟（FIGO）Ib1-IIa期宫颈癌伴盆腔淋巴结转移患者。利用临床病理资料对预后和复发情况进行回顾性分析。
总体5年生存率和5年无病生存率分别为63.3%和61.4%。总复发率为39.5%（49/124），其中盆腔内复发（61.0%，25/41）明显比盆腔外复发（31.7%，13/41；P=0.008）更常见。多因素分析确定髂总淋巴结受累是一个独立的预后因素（P=0.035）。根据该因素，淋巴结阳性患者可分为低风险组（无髂总淋巴结受累，104例）和高风险组（有髂总淋巴结受累，20例）。5年无病生存率分别为69.4%和24.5%，差异有统计学意义（P=0.003）。低风险组和高风险组分别有22.1%（23/104）和25.0%（5/20）出现盆腔内复发，差异无统计学意义（P>0.05）。然而，低风险组和高风险组分别有7.7%（8/104）和40.0%（8/20）出现盆腔外复发，差异有统计学意义（P<0.01）。
髂总淋巴结受累是影响宫颈癌伴盆腔淋巴结转移患者预后的重要因素。与髂总淋巴结阴性患者相比，髂总淋巴结阳性患者的5年无病生存率显著降低，盆腔外疾病复发率更高。这些发现为个体化治疗模式的设计提供了重要数据。
