Friedberg V, Beck T
Universitäts-Frauenklinik Mainz.
Geburtshilfe Frauenheilkd. 1989 Sep;49(9):782-6. doi: 10.1055/s-2008-1036085.
A total of 506 cases of cervix cancer, Stage Ib and IIb, operated according to Wertheim-Meigs were retrospectively (1972-1986) evaluated with their clinical and morphological aspects. After 1978 a more intensive histological evaluation of the specimen was performed, resulting in the examination of a large number of pelvic lymph nodes. The amount of lymph nodes infiltrated depends on tumour stage, invasion depth, regional lymphovascular invasion of the tumour edge and parametria, and on haemangiosis carcinomatosa. Stage pT2b cervical cancers survived five years in 81% of cases, when lymph nodes were not involved--in 69% (1-3 infiltrated l.n.) and 64% (3 infiltrated l.n.) of cases with positive lymph nodes. The five-year survival rates were further determined by the parametrial infiltration and the number of positive pelvic lymph nodes. If neither the parametria nor the lymph nodes are infiltrated by the tumor the survival rate is 96% whereas in cases of lymphovascular invasion of the parametria without infiltrated lymph nodes the rate decreases to 79%; in cases in tumor infiltration of both lymph nodes and parametria the cure rates are worst (62%). The operation of cervical cancer of Stages Ib and IIb with a thorough histological evaluation of the excised tissue therefore has a high prognostic value, but it also probably has better cure rates than is the case with radiological treatment.
对1972年至1986年间按照韦特海姆-梅格斯手术法进行手术的506例Ib期和IIb期宫颈癌病例进行了临床和形态学方面的回顾性评估。1978年之后，对标本进行了更深入的组织学评估，从而检查了大量盆腔淋巴结。淋巴结受浸润的情况取决于肿瘤分期、浸润深度、肿瘤边缘和宫旁组织的区域淋巴管浸润以及癌性血行转移。pT2b期宫颈癌在无淋巴结受累时，81%的病例存活5年；在有阳性淋巴结的病例中，1~3个淋巴结受浸润的病例中这一比例为69%，3个以上淋巴结受浸润的病例中为64%。五年生存率还由宫旁组织浸润情况和盆腔阳性淋巴结数量决定。如果肿瘤既未浸润宫旁组织也未浸润淋巴结，生存率为96%；而在宫旁组织有淋巴管浸润但无淋巴结浸润的病例中，这一比例降至79%；在肿瘤同时浸润淋巴结和宫旁组织的病例中，治愈率最差（62%）。因此，对Ib期和IIb期宫颈癌手术切除组织进行全面的组织学评估具有很高的预后价值，而且其治愈率可能也高于放射治疗。
