Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ann Oncol. 2011 Jan;22(1):59-67. doi: 10.1093/annonc/mdq321. Epub 2010 Jul 1.
this study investigated the outcomes after radical hysterectomy according to tumor size divided by 2-cm interval in patients with International Federation of Obstetrics and Gynecology stage IA2-IIA cervical cancer.
a total of 1415 patients were eligible for participation in the study and were retrospectively analyzed. Patients were divided into four groups according to tumor size (i.e. ≤ 2, 2-4, 4-6 and >6 cm). The relationships between tumor size and other clinicopathologic risk factors, the probability of adjuvant therapy, survival parameters, recurrence-free survival (RFS) and overall survival (OS) were analyzed.
the incidence of intermediate- and high-risk factors gradually increased with increasing tumor size. Adjuvant therapy was required in 13.6%, 34.0%, 56.7% and 92.9% of patients with tumor sizes of ≤ 2, 2-4, 4-6 and >6 cm, respectively (P < 0.001). The risks of recurrence and death gradually increased with increasing tumor size, after adjusting for other significant prognostic factors in multivariate analysis (P < 0.001 and < 0.001, respectively). Even in patients with no intermediate- or high-risk factors, tumor size was a significant predictor of RFS and OS (P < 0.001 and < 0.001, respectively). Immediate surgical parameters did not significantly differ according to tumor size.
tumor size divided by a 2-cm interval was an independent prognostic factor and correlated well with other risk factors and with the need for adjuvant therapy.
本研究调查了国际妇产科联合会（FIGO）分期为 IA2-IIA 期宫颈癌患者，按肿瘤大小每 2cm 间隔划分后的根治性子宫切除术的结局。
共有 1415 例患者符合入组条件并进行了回顾性分析。患者根据肿瘤大小分为四组（即≤2cm、2-4cm、4-6cm 和>6cm）。分析肿瘤大小与其他临床病理危险因素、辅助治疗概率、生存参数、无复发生存（RFS）和总生存（OS）之间的关系。
中高危因素的发生率随着肿瘤大小的增加而逐渐增加。肿瘤大小为≤2cm、2-4cm、4-6cm 和>6cm 的患者分别有 13.6%、34.0%、56.7%和 92.9%需要辅助治疗（P<0.001）。在多因素分析中，调整其他显著预后因素后，复发和死亡的风险随着肿瘤大小的增加而逐渐增加（P<0.001 和<0.001）。即使在没有中高危因素的患者中，肿瘤大小也是 RFS 和 OS 的显著预测因素（P<0.001 和<0.001）。根据肿瘤大小，即时手术参数没有显著差异。
肿瘤大小每 2cm 间隔划分是一个独立的预后因素，与其他危险因素和辅助治疗的需求密切相关。
