Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China.
Int J Surg. 2017 Aug;44:1-6. doi: 10.1016/j.ijsu.2017.05.074. Epub 2017 Jun 2.
To assess the survival outcomes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-IIA adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the uterine cervix after hysterectomy and adjuvant radiotherapy (RT).
Patients with a primary diagnosis of FIGO stage I-IIA AC or SCC of the uterine cervix after hysterectomy and adjuvant RT between 1988 and 2012 were included using data from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were used to analyze the effect of histologic subtype on cause-specific survival (CSS) and overall survival (OS).
We included 1171 patients: 919 with cervical SCC and 252 with cervical AC. In multivariate analysis, cervical AC was an independent adverse prognostic factor for survival. Patients with cervical AC had worse CSS (p = 0.001) and OS (p = 0.001) compared to patients with cervical SCC. In the subgroup analysis, patients with cervical SCC in the era of concurrent chemoradiotherapy (CCRT) (2000-2012) had better CSS (p = 0.006) and OS (p = 0.004) compared with the era of RT. However, there was no significant difference in CSS (p = 0.079) and OS (p = 0.053) between the eras of RT (1988-1999) and CCRT for patients with cervical AC.
Survival of cervical AC is significantly worse than that of cervical SCC. As CCRT usage increases, the survival benefit is derived only in cervical SCC, but not in cervical AC.
评估子宫颈国际妇产科联合会（FIGO）I-IIA 期腺癌（AC）或鳞癌（SCC）患者在子宫切除术后接受辅助放疗（RT）后的生存结局。
使用监测、流行病学和最终结果（SEER）数据库中的数据，纳入 1988 年至 2012 年间接受子宫切除术后辅助 RT 的原发性 FIGO I-IIA 期 AC 或 SCC 患者。采用单因素和多因素 Cox 回归分析，分析组织学亚型对特定原因生存率（CSS）和总生存率（OS）的影响。
共纳入 1171 例患者：919 例宫颈 SCC，252 例宫颈 AC。多因素分析显示，宫颈 AC 是生存的独立不良预后因素。与宫颈 SCC 患者相比，宫颈 AC 患者的 CSS（p=0.001）和 OS（p=0.001）更差。亚组分析显示，同期放化疗（CCRT）时代（2000-2012 年）的宫颈 SCC 患者 CSS（p=0.006）和 OS（p=0.004）均优于 RT 时代。然而，对于宫颈 AC 患者，RT 时代（1988-1999 年）与 CCRT 时代 CSS（p=0.079）和 OS（p=0.053）无显著差异。
宫颈 AC 的生存明显差于宫颈 SCC。随着 CCRT 的应用增加，生存获益仅见于宫颈 SCC，而不在宫颈 AC。
