Shen Zhen, Zhou Ying, Cheng Yong, Li Min, Wu Dabao
Department of Obstetrics and Gynecology, Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui 230000, P.R. China.
Department of Oncological Radiotherapy, Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui 230000, P.R. China.
Mol Clin Oncol. 2018 Feb;8(2):352-355. doi: 10.3892/mco.2017.1517. Epub 2017 Nov 27.
Cervical stump cancer is a rare type of disease as total hysterectomies are performed infrequently. The purpose of this retrospective study was to assess the diagnosis, treatment, follow-up methods and complications of 10 patients with cervical stump carcinoma treated with surgery in Anhui Provincial Hospital affiliated to Anhui Medical University (Hefei, China). From January 2006 to October 2016 a total of 10 patients underwent surgery for carcinoma of the cervical stump. The pathological reports revealed 80% of cases were squamous cell carcinoma and 20% of cases were adenocarcinoma. The FIGO stage distribution was as follows: Carcinoma (10%); IB (70%); IIA (20%). The patients received a transvaginal trachelectomy or a radical trachelectomy and pelvic lymphadenectomy (either laparoscopic or laparotomic abdominal); four of the patients were treated with adjuvant chemotherapy, and two with concurrent chemoradiotherapy. The parametrial and resection margin infiltration, lymph node metastasis and lymph vascular space invasion (LVSI) were negative in all patients, and the deep stromal invasion rate was 66.7% (6/9). No incidences of recurrence or mortality were recorded during the follow-up interval of 6-120 months. Compared with the four patients who received laparotomic abdominal surgery, significantly less blood loss was recorded for the five patients who underwent laparoscopic surgery (P<0.01). There was no significant difference observed in the surgery time (P>0.01) or in the hospital stay duration (P>0.01) for the patients treated with laparotomic abdominal surgery and laparoscopic surgery. One patient experienced bladder fistula due to bladder over-dilation, but recovered quickly after the catheter was reinserted. Surgery for cervical stump cancer at an early-stage is a viable and safer procedure, particularly the laparoscopic approach.
宫颈残端癌是一种罕见疾病，因为全子宫切除术并不常用。本回顾性研究旨在评估安徽医科大学附属安徽省立医院（中国合肥）10例接受手术治疗的宫颈残端癌患者的诊断、治疗、随访方法及并发症情况。2006年1月至2016年10月，共有10例患者接受了宫颈残端癌手术。病理报告显示，80%的病例为鳞状细胞癌，20%为腺癌。国际妇产科联盟（FIGO）分期分布如下：Ⅰ期（10%）；ⅠB期（70%）；ⅡA期（20%）。患者接受了经阴道宫颈切除术或根治性宫颈切除术及盆腔淋巴结清扫术（腹腔镜或开腹手术）；4例患者接受了辅助化疗，2例接受了同步放化疗。所有患者的宫旁和切缘浸润、淋巴结转移及脉管间隙浸润（LVSI）均为阴性，深部间质浸润率为66.7%（6/9）。在6至120个月的随访期内，未记录到复发或死亡病例。与4例接受开腹手术的患者相比，5例接受腹腔镜手术的患者术中出血量明显较少（P<0.01）。接受开腹手术和腹腔镜手术的患者在手术时间（P>0.01）或住院时间（P>0.01）方面未观察到显著差异。1例患者因膀胱过度扩张出现膀胱瘘，但重新插入导尿管后很快康复。早期宫颈残端癌手术是一种可行且更安全的手术方式，尤其是腹腔镜手术。
