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评价 II 型根治性子宫切除术治疗 960 例 IB-IIB 期宫颈癌患者的效果:一项回顾性研究。

Evaluation of the effects of type II radical hysterectomy in the treatment of 960 patients with stage IB-IIB cervical carcinoma: A retrospective study.

机构信息

State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong, P. R. China.

出版信息

J Surg Oncol. 2011 Apr;103(5):435-41. doi: 10.1002/jso.21800. Epub 2010 Dec 7.

Abstract

BACKGROUND AND OBJECTIVES

This retrospective study evaluated the feasibility and effectiveness of type II radical hysterectomies alone, or in combination with adjuvant treatment, for the treatment of patients with stage IB-IIB cervical cancer with or without high-risk factors.

METHODS

A total of 960 stage IB-IIB patients who underwent type II radical hysterectomies between 1995 and 2004 were enrolled and retrospectively analyzed.

RESULTS

Uterine corpus invasion, parametrial margin involvement, and pelvic lymph node metastasis were identified as independent prognostic factors for stage IB patients. For stage IIA-IIB patients, histologic type, parametrial margin involvement, and pelvic lymph node metastasis were identified as independent prognostic factors. The 5-year overall survival (OS) rates for patients with stage IB versus stage IIA-IIB cervical carcinomas were 88.4% and 78.5%, respectively. Moreover, adjuvant radiotherapy and chemotherapy improved the 5-year OS rates of stage IIA-IIB patients associated with high-risk factors. The overall recurrence rate for this cohort was 14.4%.

CONCLUSIONS

Our findings show that type II radical hysterectomy is a feasible treatment option for stage IB-IIB cervical carcinoma patients. Furthermore, type II radical hysterectomy combined with adjuvant post-operative therapy improves the OS of women with high-risk factors for cervical carcinoma.

摘要

背景与目的

本回顾性研究评估了单纯行 II 型根治性子宫切除术或联合辅助治疗对有或无高危因素的 IB-IIB 期宫颈癌患者的可行性和有效性。

方法

共纳入 1995 年至 2004 年间接受 II 型根治性子宫切除术的 960 例 IB-IIB 期患者,并进行回顾性分析。

结果

子宫体侵犯、宫旁切缘受累和盆腔淋巴结转移被确定为 IB 期患者的独立预后因素。对于 IIA-IIB 期患者,组织学类型、宫旁切缘受累和盆腔淋巴结转移被确定为独立的预后因素。IB 期与 IIA-IIB 期宫颈癌患者的 5 年总生存率(OS)分别为 88.4%和 78.5%。此外,高危因素的 IIA-IIB 期患者接受辅助放疗和化疗可提高 5 年 OS 率。该队列的总体复发率为 14.4%。

结论

我们的研究结果表明,II 型根治性子宫切除术是治疗 IB-IIB 期宫颈癌患者的可行选择。此外,II 型根治性子宫切除术联合辅助术后治疗可提高宫颈癌高危因素妇女的 OS。

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