Khatib Ghanim, Küçükgöz Güleç Ümran, Bariş Güzel Ahmet, Uygur Berk, Seydaoğlu Gülşah, Gümürdülü Derya, Vardar Mehmet Ali
*Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Çukurova University, Adana; †Department of Obstetrics and Gynecology, Kirikkale Government Hospital, Kirikkale; and ‡Department of Biostatistic, Faculty of Medicine, and §Department of Pathology, Division of Gynecologic Pathology, Faculty of Medicine, Çukurova University, Adana, Turkey.
Int J Gynecol Cancer. 2016 Oct;26(8):1480-4. doi: 10.1097/IGC.0000000000000786.
The aim of this study is to evaluate the results of radical surgery in patients with stage IB2 to IIA2 cervical cancer who were operated on at our center between 2002 and 2015.
Forty-seven cases of patients with stage IB2/IIA2 cervical cancer who underwent primary radical surgery between 2002 and 2015 were enrolled in this study. Patients' files and pathological reports were retrospectively reviewed. Surgical, pathological, and clinical variables were analyzed and their impact on survival period was researched. Disease-free survival and overall survival periods were determined using the Kaplan-Meier test. The P value was considered significant if less than 0.05.
Type C2 radical hysterectomy with lymphadenectomy (5 pelvic, 42 pelvic and para-aortic) was performed for all of the 47 patients in accordance with the Querleu-Morrow classification. Thirty-three of the cases were stage Ib2 and 14 cases were IIa2. Five years of overall survival was 80%. Recurrence was noted in 10 (7 pelvic, 3 extrapelvic) patients. Adjuvant therapies were needed for 83% of the patients. A univariate analysis was made for all included variables in this research and, other than recurrence, none of them was found to be statistically significant on OS and DFS.
Although adjuvant therapies are often resorted to, primary radical surgery is also a reasonable treatment option for stage IB2/IIA2 cervical cancer, especially in young premenopausal patients when preserving ovarian functions is desired.
本研究旨在评估2002年至2015年期间在本中心接受手术的IB2至IIA2期宫颈癌患者的根治性手术结果。
本研究纳入了2002年至2015年间接受初次根治性手术的47例IB2/IIA2期宫颈癌患者。对患者的病历和病理报告进行回顾性分析。分析手术、病理和临床变量,并研究它们对生存期的影响。采用Kaplan-Meier检验确定无病生存期和总生存期。P值小于0.05被认为具有统计学意义。
根据Querleu-Morrow分类,对所有47例患者均实施了C2型根治性子宫切除术及淋巴结清扫术(5例盆腔淋巴结清扫,42例盆腔及腹主动脉旁淋巴结清扫)。其中33例为Ib2期,14例为IIa2期。5年总生存率为80%。10例(7例盆腔复发,3例盆腔外复发)出现复发。83%的患者需要辅助治疗。对本研究中纳入的所有变量进行单因素分析,除复发外,其他因素在总生存期和无病生存期方面均未发现具有统计学意义。
尽管经常采用辅助治疗,但对于IB2/IIA2期宫颈癌,根治性手术也是一种合理的治疗选择,尤其是对于希望保留卵巢功能的年轻绝经前患者。