Yan Ding-Ding, Tang Qiu, Chen Jian-Hong, Tu Ye-Qiang, Lv Xiao-Juan
Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
Cancer Manag Res. 2019 Jun 13;11:5473-5480. doi: 10.2147/CMAR.S203059. eCollection 2019.
To determine the predictive value of the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer patients with surgical risk factors. Data of 662 cervical cancer patients (stages IB and IIA) with surgical risk factors treated at Zhejiang Cancer Hospital between 2008 and 2011 were retrospectively reviewed. Univariate log-rank test and multivariate Cox regression models were adopted to evaluate the relationship between 2018 FIGO stage and survival. On re-staging of patients, 17.3%, 44.5%, 25.4%, and 37.1% of the patients with FIGO 2009 stage IB1, IB2, IIA1, and IIA2, respectively, were upgraded to FIGO 2018 IIIC1P stage, and 2.1%, 3.0%, 3.1%, and 2.1% patients, respectively, were upgraded to IIIC2P stage. The 5-year overall survival (OS) rates of patients with FIGO 2018 stage IB1, IB2, IB3, IIA1, IIA2, IIIC1P, and IIIC2P were 95.3%, 95.1%, 90.4%, 92.4%, 86.4%, 81.9%, and 56.3%, respectively. The 5-year progression-free survival (PFS) rates were 94.0%, 91.0%, 88.5%, 91.4%, 86.4%, 79.5%, and 43.8%, respectively. The 5-year OS rates of patients with 1-2 positive pelvic lymph nodes (PLNs) and those with >2 positive PLNs were 86.0% and 73.7%, respectively, and the 5-year PFS rates were 84.2% and 70.2%, respectively. OS and PFS of patients with 1-2 positive PLNs in stage IIIC1P were similar to those of patients in stage IIA2 without lymph node metastasis, but significantly better than those of patients with >2 positive PLNs. Multivariate analysis showed FIGO 2018 stage to be an independent prognostic factor for OS and PFS. The 2018 FIGO staging system for cervical cancer appears to be useful for predicting prognosis of patients with risk factors after radical surgery. Survival of stage IIA1 patients is better than that of stage IB3 patients. Stage IIIC1 is not homogenous; survival in stage IIIC1P depends on the number of positive PLNs.
确定2018年国际妇产科联盟（FIGO）分期系统对具有手术风险因素的宫颈癌患者的预测价值。回顾性分析了2008年至2011年在浙江省肿瘤医院接受治疗的662例具有手术风险因素的宫颈癌患者（IB期和IIA期）的数据。采用单因素对数秩检验和多因素Cox回归模型评估2018年FIGO分期与生存之间的关系。在对患者进行重新分期时，2009年FIGO分期为IB1、IB2、IIA1和IIA2的患者中，分别有17.3%、44.5%、25.4%和37.1%被升级为2018年FIGO IIIC1P期，分别有2.1%、3.0%、3.1%和2.1%的患者被升级为IIIC2P期。2018年FIGO分期为IB1、IB2、IB3、IIA1、IIA2、IIIC1P和IIIC2P的患者的5年总生存率（OS）分别为95.3%、95.1%、90.4%、92.4%、86.4%、81.9%和56.3%。5年无进展生存率（PFS）分别为94.0%、91.0%、88.5%、91.4%、86.4%、79.5%和43.8%。盆腔淋巴结（PLN）1 - 2个阳性的患者和PLN阳性数>2个的患者的5年OS率分别为86.0%和73.7%，5年PFS率分别为84.2%和70.2%。IIIC1P期PLN 1 - 2个阳性的患者的OS和PFS与IIA2期无淋巴结转移的患者相似，但明显优于PLN阳性数>2个的患者。多因素分析显示，2018年FIGO分期是OS和PFS的独立预后因素。2018年FIGO宫颈癌分期系统似乎有助于预测根治性手术后具有风险因素患者的预后。IIA1期患者的生存率优于IB3期患者。IIIC1期并非同质；IIIC1P期的生存率取决于阳性PLN的数量。
