Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ann Oncol. 2010 May;21(5):994-1000. doi: 10.1093/annonc/mdp426. Epub 2009 Oct 25.
To estimate safety and efficacy of radical parametrectomy (RP) and radiation therapy (RT) or concurrent chemoradiation therapy (CCRT) for patients with occult invasive cervical cancer found after simple hysterectomy.
We retrospectively evaluated outcomes in 147 patients with occult invasive cervical cancer.
Forty-eight patients with IA1 lesions (IA1 group) did not receive further treatment. Of the 99 patients with IA2-IIA lesions, 26 received no definitive treatment (observation group), 44 received RT or CCRT (RT/CCRT group), and 29 underwent RP (RP group). After a median follow-up of 116 months (range 3-235 months), recurrent disease was observed in 0%, 34.6%, 6.8%, and 0% of patients in the IA1, observation, RT/CCRT, and RP groups, respectively. In the RT/CCRT group, treatment was delayed due to severe diarrhea in 4 patients (9%) and 12 patients (27%) had late complications related to RT requiring further management (including two surgical interventions). Five patients in the RP group (17%) experienced perioperative complications which were easily managed, intraoperatively or conservatively. Late complications were not observed in the RP group.
Although RP and RT/CCRT had similar therapeutic efficacy, the lower rate of late complications observed with RP makes it preferable to RT/CCRT.
评估单纯子宫切除术后发现隐匿性浸润性宫颈癌患者行根治性盆腔廓清术（RP）联合放疗（RT）或同期放化疗（CCRT）的安全性和有效性。
我们回顾性评估了 147 例隐匿性浸润性宫颈癌患者的结局。
48 例 IA1 期患者（IA1 组）未接受进一步治疗。99 例 IA2-IIA 期患者中，26 例未行确定性治疗（观察组），44 例行 RT 或 CCRT（RT/CCRT 组），29 例行 RP（RP 组）。中位随访 116 个月（3-235 个月）后，IA1、观察组、RT/CCRT 组和 RP 组患者的疾病复发率分别为 0%、34.6%、6.8%和 0%。在 RT/CCRT 组，4 例（9%）患者因严重腹泻而延迟治疗，12 例（27%）患者因 RT 相关的迟发性并发症需要进一步治疗（包括 2 例手术干预）。RP 组 5 例（17%）患者发生围手术期并发症，经手术或保守治疗即可处理。RP 组未观察到迟发性并发症。
尽管 RP 和 RT/CCRT 的治疗效果相似，但 RP 组迟发性并发症发生率较低，优于 RT/CCRT。
