Nakayama K, Teshima H, Hirai Y, Hasumi K, Masubuchi K
Department of Gynecology, Cancer Institute Hospital, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1990 Mar;42(3):241-5.
Of a total of 1,025 cases of radical hysterectomy for histological squamous cell carcinoma (543 stage I cases and 482 stage II cases), we examined 50 cases of recurrence of the carcinoma (4.9 percent; 24 stage I cases and 26 stage II cases) at the site of the vaginal stump. The percentage of recurrence at the site of the vaginal stump was significantly higher in stage I and stage II cases, in which metastases to the lymph nodes or vascular invasion was observed (p less than 0.01). The length of vagina excised during the radical hysterectomy was measured and its relationship to recurrence at the site of the vaginal stump was investigated. In stage I cases that did not exhibit metastases to the lymph nodes, the shortest vaginal length excised in cases with a positive recurrence at the site of the vaginal stump was 2.5 +/- 0.9 cm; the shortest vaginal length in cases with a negative recurrence at the site of the vaginal stump was 1.8 +/- 0.8 cm. A significant difference (p less than 0.05) was observed between them. Furthermore, in stage I cases with no metastases to the lymph nodes, one recurrence at the site of the vaginal stump was observed when the vaginal length excised was 3 cm. In stage I cases with metastases to the lymph nodes and in stage II cases, no significant difference was discovered between the length of vagina excised in cases with positive and those with negative recurrences of the carcinoma at the site of the vaginal stump.
在总共1025例因组织学鳞状细胞癌而行根治性子宫切除术的病例中(I期病例543例,II期病例482例),我们检查了50例癌复发(4.9%;I期病例24例,II期病例26例)发生在阴道残端部位的情况。I期和II期病例中,若观察到有淋巴结转移或血管侵犯,则阴道残端部位的复发百分比显著更高(p<0.01)。测量了根治性子宫切除术中切除的阴道长度,并研究了其与阴道残端部位复发的关系。在未出现淋巴结转移的I期病例中,阴道残端复发阳性的病例中切除的最短阴道长度为2.5±0.9cm;阴道残端复发阴性的病例中最短阴道长度为1.8±0.8cm。两者之间观察到显著差异(p<0.05)。此外,在未出现淋巴结转移的I期病例中,当切除的阴道长度为3cm时,观察到1例阴道残端部位复发。在出现淋巴结转移的I期病例和II期病例中,阴道残端癌复发阳性和阴性的病例之间切除的阴道长度未发现显著差异。