Gynecological Oncology Radiumhemmet, Department of Oncology, Karolinska University Hospital, Solna, Stockholm, Sweden.
Oncol Rep. 2011 Jun;25(6):1651-4. doi: 10.3892/or.2011.1228. Epub 2011 Mar 22.
A series of patients with carcinoma of the cervical stump in relation to age, clinical stage, histopathology, changes in relative incidence, treatment outcome and long-term survival, were studied and the findings were compared with matched controls that have an intact uterus and cancer of the cervix. Of 8,028 women treated for invasive cervical carcinoma between 1959-2004, 161 were diagnosed with stump cancer, accounting for 2.0% of all cervical cancers. The mean time interval between subtotal hysterectomy and stump cancer diagnosis was 17.6 years, with a range of 1-46 years. In 80% of cases, symptoms drove the patient to seek medical attention and postcoital, intermenstrual or postmenopausal bleeding was the main reason. Among 161 stump cancer cases 89% were squamous cell carcinoma (SCC) and the remaining 17 cases were adenocarcinomas (AC). Cumulative cause-specific survival rate was significantly worse for adenocarcinoma than for squamous cell carcinoma (SCC) of the cervical stump (Log-rank p = 0.027, Cox-Mantel p = 0.015, Cox F-test p = 0.01). The stump cancer cases show a worse stage profile compared with the cancer cases in intact uterus. We conclude that the total effect of stump cancers following subtotal hysterectomies is not to be neglected.
对一系列与年龄、临床分期、组织病理学、相对发病率变化、治疗结果和长期生存有关的宫颈残端癌患者进行了研究，并将研究结果与具有完整子宫和宫颈癌的匹配对照组进行了比较。在 1959 年至 2004 年间接受浸润性宫颈癌治疗的 8028 名女性中，有 161 名被诊断为残端癌，占所有宫颈癌的 2.0%。次全子宫切除术与残端癌诊断之间的平均时间间隔为 17.6 年，范围为 1-46 年。在 80%的病例中，症状促使患者寻求医疗，性交后、月经间或绝经后出血是主要原因。在 161 例残端癌中，89%为鳞状细胞癌（SCC），其余 17 例为腺癌（AC）。残端宫颈癌的累积特定原因生存率明显低于宫颈 SCC（对数秩检验 p = 0.027，Cox-Mantel 检验 p = 0.015，Cox F 检验 p = 0.01）。与具有完整子宫的癌症病例相比，残端癌病例的分期情况更差。我们得出结论，次全子宫切除术引起的残端癌的总体影响不容忽视。
