Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Chin Med J (Engl). 2018 Jul 5;131(13):1541-1548. doi: 10.4103/0366-6999.235111.
Pelvic exenteration (PE) for primary and recurrent cervical cancer has resulted in favorable survival outcomes, but there are controversies about specific prognosis factors, and up to now, there have been no published reports from China. This study aimed to share our experiences of PE, which were performed in a single institution.
From January 2009 to January 2016, 38 patients with recurrent or persistent cervical cancer were included in the study, and they were followed up until January 2017. Epidemiological and clinicopathological characteristics of patients were compared for survival outcomes in univariate and Cox hazard regression analysis.
There were thirty-one and seven patients with recurrent and persistent cervical cancer, respectively. The median age of patients was 45 years (range 29-65 years). Total, anterior, and posterior PE consisted of 52.6%, 28.9%, and 18.4% of cases, respectively. Early and late complications occurred in 21 (55.3%) patients and 15 (39.5%) patients, respectively. Two (5.3%) patients died due to complications related to surgeries within 3 months after PE. The median overall survival (OS) and disease-free survival (DFS) were 28.5 months (range 9-96 months) and 23 months (range 4-96 months), respectively, and 5-year OS and DFS were 48% and 40%, respectively. Cox hazard regression analysis showed that, the margin status of the incision and mesorectal lymph node status were independent risk factors for OS and DFS.
In our patients with recurrent and persistent cervical cancer, the practice of PE might achieve favorable survival outcomes.
ClinicalTrials.gov, NCT03291275; https://clinicaltrials.gov/ct2/show/NCT03291275?term=NCT03291275&rank=1.
盆腔廓清术（pelvic exenteration，PE）用于原发性和复发性宫颈癌患者已取得较好的生存获益，但具体的预后因素仍存在争议，且目前尚未有来自中国的相关报道。本研究旨在分享我们在单一机构实施的盆腔廓清术经验。
本研究回顾性分析了 2009 年 1 月至 2016 年 1 月间 38 例复发性或持续性宫颈癌患者的临床资料，随访至 2017 年 1 月。通过单因素和 Cox 风险回归分析比较患者的流行病学和临床病理特征，以评估生存结果。
其中 31 例患者为复发性宫颈癌，7 例患者为持续性宫颈癌。患者的中位年龄为 45 岁（2965 岁）。全盆腔、前盆腔和后盆腔廓清术分别占 52.6%、28.9%和 18.4%。21 例（55.3%）患者发生早期并发症，15 例（39.5%）患者发生晚期并发症。2 例（5.3%）患者术后 3 个月内因与手术相关的并发症死亡。中位总生存（overall survival，OS）和无疾病生存（disease-free survival，DFS）时间分别为 28.5 个月（996 个月）和 23 个月（4~96 个月），5 年 OS 和 DFS 分别为 48%和 40%。Cox 风险回归分析显示，切缘状态和中直肠淋巴结状态是 OS 和 DFS 的独立危险因素。
在我们的复发性和持续性宫颈癌患者中，实施盆腔廓清术可能获得较好的生存结果。
ClinicalTrials.gov，NCT03291275；https://clinicaltrials.gov/ct2/show/NCT03291275?term=NCT03291275&rank=1.
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