Chen Ming, Pan Lingya
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Email:
Zhonghua Fu Chan Ke Za Zhi. 2014 Jun;49(6):460-5.
To evaluate the current status and outcomes of pelvic exenteration (PE) for recurrent cervical cancer.
The following electronic databases has been searched on recurrent cervical cancer management and treatment:Chinese Biological Medicine Disk (CBM), PubMed and Cochrane library. All retrieved studies had to fulfill the following inclusion criteria: cohort studies of recurrent cervical cancer, containing information of detailed patient and operation characteristics as well as the survival rate. Only publications in the English literature were included. All eligible literatures between Jan. 1990 and Aug. 2013 were assessed for quality. Relevant basic characteristics, complications, survival rate and prognostic factors were reviewed.
There were eight trials involving 607 patients with cervical cancer received PE, including 515 cases with recurrent disease and 92 cases with primary disease. Four hundred and ninety patients had received total pelvic exenteration (TPE) operation, 103 underwent anterior pelvic exenteration (APE) and 14 received posterior pelvic exenteration (PPE). The 5-year overall survival rate for recurrent cervical cancer fluctuate from 26.7% to 56.0%. Complication rates were from 34.3% to 83.3% and the mortality rate was 1.2% (7/607). Among the relevant factors affecting survival time, resection margin status seemed to be the most important.
Based on this systematic review, PE does help improve the survival of recurrent cervical cancer patients on the basis of strict selection of candidates.
评估复发性宫颈癌盆腔廓清术（PE）的现状及治疗结果。
检索了以下关于复发性宫颈癌管理与治疗的电子数据库：中国生物医学文献数据库（CBM）、PubMed和Cochrane图书馆。所有检索到的研究必须符合以下纳入标准：复发性宫颈癌的队列研究，包含详细的患者和手术特征信息以及生存率。仅纳入英文文献中的出版物。对1990年1月至2013年8月期间所有符合条件的文献进行质量评估。回顾相关的基本特征、并发症、生存率和预后因素。
有八项试验涉及607例接受PE的宫颈癌患者，其中515例为复发性疾病，92例为原发性疾病。490例患者接受了全盆腔廓清术（TPE），103例接受了前盆腔廓清术（APE），14例接受了后盆腔廓清术（PPE）。复发性宫颈癌的5年总生存率在26.7%至56.0%之间波动。并发症发生率为34.3%至83.3%，死亡率为1.2%（7/607）。在影响生存时间的相关因素中，切缘状态似乎是最重要的。
基于这项系统评价，在严格筛选患者的基础上，PE确实有助于提高复发性宫颈癌患者的生存率。
