Han Y, Wu L Y, Li N, Li X G, Zhang R, Sun Y C
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2017 May 23;39(5):369-373. doi: 10.3760/cma.j.issn.0253-3766.2017.05.010.
To study the efficacy of surgery for recurrent cervical cancer and the influencing factors on prognosis. To retrospectively analyze the clinical data of 45 patients with recurrent cervical cancer undergoing surgical treatment in our hospital from January 1980 to October 2015, and study their clinical features and prognosis. The Recurrence Free Interval (RFI) of these 45 patients was 3~120 months, and their median RFI was 15 months. Of the 45 cases, 21 recurred inside the radiotherapy field, including 18 with central recurrence and 3 with non-central recurrence; and 24 recurred outside the radiotherapy field, including 16 with pelvic recurrence who did not receive radiotherapy and 8 with distant recurrence. The overall survival time after recurrence of these 45 cases was (39.1±1.0) months, and their 2-year and 5-year survival rates were 55.6% and 22.2%, respectively. The univariate analysis showed that clinical stage, RFI, recurrent site, and initial treatment method affected the survival rate of the patients with recurrent cervical cancer (<0.05), while the multivariate analysis revealed that recurrent site was an independent prognostic factor for recurrent cervical cancer (=0.047). Appropriate surgery should be chosen for recurrent cervical cancer according to initial treatment and recurrent site. For patients with central recurrence inside their radiotherapy field, surgery is an effective treatment. Surgery is also suitable for patients without previous radiotherapy and with isolated recurrence, and adjuvant radiotherapy and chemotherapy can improve their survival.
研究复发性宫颈癌手术的疗效及预后的影响因素。回顾性分析1980年1月至2015年10月在我院接受手术治疗的45例复发性宫颈癌患者的临床资料，研究其临床特征及预后。这45例患者的无复发生存期（RFI）为3至120个月，中位RFI为15个月。45例中，21例在放射治疗野内复发，其中18例为中心复发，3例为非中心复发；24例在放射治疗野外复发，其中16例为未接受放射治疗的盆腔复发，8例为远处复发。这45例患者复发后的总生存时间为（39.1±1.0）个月，其2年和5年生存率分别为55.6%和22.2%。单因素分析显示，临床分期、RFI、复发部位及初始治疗方式影响复发性宫颈癌患者的生存率（P<0.05），而多因素分析显示复发部位是复发性宫颈癌的独立预后因素（P=0.047）。应根据初始治疗及复发部位为复发性宫颈癌选择合适的手术方式。对于放射治疗野内中心复发的患者，手术是一种有效的治疗方法。手术也适用于既往未接受放射治疗且为孤立性复发的患者，辅助放疗及化疗可提高其生存率。
