Mossa B, Mossa S, Marziani R
Department of Gynecology, Perinatology and Child Health, II Faculty of Medicine, University "Sapienza" of Rome, Italy.
Eur J Gynaecol Oncol. 2010;31(5):545-50.
The aim of this study was to evaluate whether the addition of adjuvant chemotherapy will improve the outcomes of high-risk patients with Stage IB, IIA squamous cervical carcinoma with positive pelvic and/or aortic nodes.
127 patients with Stage IB and IIA cervical carcinoma treated with radical hysterectomy and systematic pelvic/aortic lymphadenectomy (RS) and who had lymph node involvement, confirmed at the final histological examination were enrolled from January 1987 to December 2001. All the patients received three cycles of adjuvant chemotherapy (AC) with cisplatin, bleomycin and vinblastine. The median patient age was 47.3. Seventy-seven patients had FIGO Stage IB1, 26 IB2 and 24 IIA. The results were compared with those obtained from a group of 136 patients with comparable age, stage and lymph node involvement, on whom radical surgery, systematic pelvic/aortic lymphadenectomy (RS) and adjuvant radiotherapy (RT) was performed on period 1971-1984. The followup period ranged from 7-13 years.
Overall survival rate of the two groups (RS+AC) vs (RS+RT) at seven years was 69.3% and 59.5%, respectively (chi2 = 2.70; p = .10). Progression-free survival was 59.8% vs 50.0% (chi2 = 2.56; p = .10 ns). The best results were however obtained with the common iliac and over two lymph node metastases.
Adjuvant chemotherapy in high-risk patients for lymph node positivity did not produce statistically significant results in terms of overall and disease-free survival vs adjuvant radiotherapy; however, a group of these patients, approximately 10%, could receive benefit from the treatment.
本研究旨在评估辅助化疗的加入是否会改善伴有盆腔和/或主动脉旁淋巴结阳性的IB期、IIA期高危鳞状宫颈癌患者的预后。
1987年1月至2001年12月，选取127例接受根治性子宫切除术及系统性盆腔/主动脉旁淋巴结清扫术（RS）且在最终组织学检查中证实有淋巴结受累的IB期和IIA期宫颈癌患者。所有患者接受了三个周期的顺铂、博来霉素和长春花碱辅助化疗（AC）。患者中位年龄为47.3岁。77例为国际妇产科联盟（FIGO）IB1期，26例为IB2期，24例为IIA期。将结果与1971 - 1984年期间接受根治性手术、系统性盆腔/主动脉旁淋巴结清扫术（RS）及辅助放疗（RT）的136例年龄、分期和淋巴结受累情况相当的患者的结果进行比较。随访期为7至13年。
两组（RS + AC）与（RS + RT）的7年总生存率分别为69.3%和59.5%（χ² = 2.70；p = 0.10）。无进展生存率分别为59.8%和50.0%（χ² = 2.56；p = 0.10，无统计学意义）。然而，在髂总淋巴结及两个以上淋巴结转移患者中取得了最佳结果。
对于淋巴结阳性的高危患者，辅助化疗在总生存和无病生存方面与辅助放疗相比未产生统计学显著差异；然而，其中约10%的患者群体可能从该治疗中获益。
