Kasamatsu T, Onda T, Sawada M, Kato T, Ikeda S, Sasajima Y, Tsuda H
Division of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
Br J Cancer. 2009 May 5;100(9):1400-5. doi: 10.1038/sj.bjc.6605048.
A retrospective analysis was carried out to identify risk factors for survival and relapse in patients with FIGO stage I-IIB cervical adenocarcinoma (AC), who underwent radical hysterectomy, and to compare outcome and spread pattern with those of squamous cell carcinoma (SCC). One hundred and twenty-three FIGO stage I-IIB patients with AC and 455 patients with SCC, who all underwent primary radical hysterectomy, were reviewed. Among the patients with AC, Cox model identified tumour size (95% CI: 1.35-30.71) and node metastasis (95% CI: 5.09-53.44) as independent prognostic factors for survival, and infiltration to vagina (95% CI: 1.15-5.76) and node metastasis (95% CI: 6.39-58.87) as independent prognostic factors for relapse. No significant difference was found in survival or relapse between the AC and SCC groups, after adjusting for other clinicopathological characteristics using Cox model. No significant difference was found in the positive rates of lymph nodes or location of initial failure sites between the two groups, but ovarian metastatic rate was significantly higher in patients with pathologic stage IIB AC (P=0.02). Positive node is a common independent prognostic factor for survival and relapse of patients with AC. FIGO stage I-IIB patients with AC or SCC, who underwent radical hysterectomy, have similar prognosis and spread pattern, but different ovarian metastasis rates.
进行了一项回顾性分析,以确定国际妇产科联盟(FIGO)I-IIB期宫颈腺癌(AC)患者接受根治性子宫切除术后生存和复发的危险因素,并将其结果和扩散模式与鳞状细胞癌(SCC)患者进行比较。回顾了123例FIGO I-IIB期AC患者和455例SCC患者,所有患者均接受了初次根治性子宫切除术。在AC患者中,Cox模型确定肿瘤大小(95%CI:1.35-30.71)和淋巴结转移(95%CI:5.09-53.44)是生存的独立预后因素,阴道浸润(95%CI:1.15-5.76)和淋巴结转移(95%CI:6.39-58.87)是复发的独立预后因素。使用Cox模型调整其他临床病理特征后,AC组和SCC组在生存或复发方面未发现显著差异。两组之间淋巴结阳性率或初始失败部位位置无显著差异,但病理IIB期AC患者的卵巢转移率显著更高(P=0.02)。阳性淋巴结是AC患者生存和复发的常见独立预后因素。接受根治性子宫切除术的FIGO I-IIB期AC或SCC患者具有相似的预后和扩散模式,但卵巢转移率不同。