Gynecological Oncology Centre, Department of Obstetrics and Gynecology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
Int J Gynecol Cancer. 2011 May;21(4):690-8. doi: 10.1097/IGC.0b013e318213653d.
It was the aim of our study to analyze oncological outcome and prognostic parameters in patients with early stages cervical cancer after tailored and well-standardized surgical treatment with an adequate follow-up.
Oncological outcome and prognostic parameters were evaluated in a group of 192 patients with cervical cancer stages IA2 to 2B who had undergone radical hysterectomy (n = 171), radical parametrectomy (n = 12), or radical trachelectomy (n = 9). Procedures were classified as type B (n = 72), type C1 nerve sparing (n = 103), or type C2 (n = 17).
Event-free and overall 5-year survivals probabilities reached 92.7% (confidence interval, 89.5%-95.9 %) and 94.1% (confidence interval, 90.9%-97.3 %). There was only 1 isolated pelvic recurrence found of the total of 10 recurrences. Adjuvant radiotherapy was given to only 22% of patients. The most significant independent prognostic parameters in stage IB tumors were lymph node status, histological type, and tumor volume, whereas in stage II, the parameters included histological type and tumor volume, the latter being inversely related to the prognosis.
We have shown an excellent prognosis, especially local control, after tailored surgical treatment of stages IA2 to IIB of cervical cancer, with low prevalence of adjuvant treatment. Different prognostic parameters were observed for stages IB1/IB2 and IIA/B.
本研究旨在分析经过个体化和标准化手术治疗及充分随访的早期宫颈癌患者的肿瘤学结局和预后参数。
对 192 例接受根治性子宫切除术(n=171)、根治性附件切除术(n=12)或根治性宫颈切除术(n=9)的宫颈癌 IA2 至 2B 期患者的肿瘤学结局和预后参数进行评估。手术分为 B 型(n=72)、C1 型神经保留(n=103)或 C2 型(n=17)。
无事件和总 5 年生存率分别达到 92.7%(置信区间,89.5%-95.9%)和 94.1%(置信区间,90.9%-97.3%)。在总共 10 例复发中,仅发现 1 例孤立性盆腔复发。仅 22%的患者接受了辅助放疗。IB 期肿瘤的独立预后参数最重要的是淋巴结状态、组织学类型和肿瘤体积,而 II 期肿瘤的独立预后参数包括组织学类型和肿瘤体积,后者与预后呈负相关。
我们发现,经过个体化手术治疗宫颈癌 IA2 至 IIB 期,尤其是局部控制效果极好,辅助治疗的患病率较低。IB1/IB2 期和 IIA/B 期的预后参数不同。