Chen Zhilan, Huang Kecheng, Lu Zhiyong, Deng Song, Xiong Jiaqiang, Huang Jia, Li Xiong, Tang Fangxu, Wang Zhihao, Sun Haiying, Wang Lin, Zhou Shasha, Wang Xiaoli, Jia Yao, Hu Ting, Gui Juan, Wan Dongyi, Ma Ding, Li Shuang, Wang Shixuan
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, People's Republic of China; Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, People's Republic of China.
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, People's Republic of China.
Onco Targets Ther. 2016 May 27;9:3171-9. doi: 10.2147/OTT.S94151. eCollection 2016.
The purpose of this study was to identify risk factors in patients with surgically treated node-positive IB1-IIB cervical cancer and to establish a risk model for disease-free survival (DFS) and overall survival (OS). A total of 170 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for node-positive International Federation of Gynaecology and Obstetrics (FIGO) stage IB1-IIB cervical cancer from January 2002 to December 2008 were retrospectively analyzed. Five published risk models were evaluated in this population. The variables, including common iliac lymph node metastasis and parametrial invasion, were independent predictors of outcome in a multivariate analysis using a Cox regression model. Three distinct prognostic groups (low, intermediate, and high risk) were defined using these variables. Five-year DFS rates for the low-, intermediate-, and high-risk groups were 73.7%, 60.0%, and 25.0%, respectively (P<0.001), and 5-year OS rates were 81.9%, 42.8%, and 25.0%, respectively (P<0.001). The risk model derived in this study provides a novel means for assessing prognosis of patients with node-positive stage IB1-IIB cervical cancer. Future study will focus on external validation of the model and refinement of the risk scoring systems by adding new biologic markers.
本研究的目的是确定接受手术治疗的淋巴结阳性IB1-IIB期宫颈癌患者的危险因素，并建立无病生存期（DFS）和总生存期（OS）的风险模型。对2002年1月至2008年12月期间因淋巴结阳性国际妇产科联盟（FIGO）IB1-IIB期宫颈癌接受根治性子宫切除术和双侧盆腔淋巴结清扫术作为主要治疗的170例患者进行了回顾性分析。在该人群中评估了五个已发表的风险模型。在使用Cox回归模型的多变量分析中，包括髂总淋巴结转移和宫旁浸润在内的变量是结局的独立预测因素。使用这些变量定义了三个不同的预后组（低、中、高风险）。低、中、高风险组的5年DFS率分别为73.7%、60.0%和25.0%（P<0.001），5年OS率分别为81.9%、42.8%和25.0%（P<0.001）。本研究得出的风险模型为评估淋巴结阳性IB1-IIB期宫颈癌患者的预后提供了一种新方法。未来的研究将集中于该模型的外部验证以及通过添加新的生物标志物来完善风险评分系统。
