Tsunetoh Satoshi, Terai Yoshito, Takai Masaaki, Fujiwara Satoe, Tanaka Yoshimichi, Tanaka Tomohito, Sasaki Hiroshi, Ibuki Naokazu, Ubai Takanobu, Yamamoto Kazuhiro, Azuma Haruhito, Ohmichi Masahide
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan.
Department of Obstetrics and Gynecology, Kobe University, Kobe, Japan.
Oncotarget. 2019 Aug 27;10(50):5207-5216. doi: 10.18632/oncotarget.27147.
Our purposes of this study were to characterize a group of bulky cervical cancer patients who underwent a nerve sparing radical hysterectomy (NSRH) with or without neoadjuvant chemotherapy (NAC), to compare surgical outcomes and the preservation of bladder function, and to compare prognoses. Fifty-three patients had NSRH without NAC (Group A), and 33 patients had NSRH after NAC (Group B). With regard to prognostic factors, there was only a significant difference between both groups with regard to lymph node metastasis (15% vs 42%, = 0.01). Moreover, bladder function in Group B patients improved to the same extent as the preoperative rate three months postoperatively. These data were similar to the results in Group A. With regard to overall survival, the 5-year survival rate was 98.1% (95% confidence interval (CI) 87.8-99.7) in Group A and 86.7% (95% CI 71.7-96.7) in Group B ( > 0.1). We retrospectively identified 86 patients with cervical cancer who underwent NSRH at Osaka Medical College from May 2009 to November 2016. NAC was performed via balloon occluded arterial infusion. We extracted data on the patient's stage of progress, tumor volume, histological subtype, bleeding volume, urodynamic study results, and postoperative complications. The data were divided into two groups - those patients who received NAC and those who did not - and then compared. According to our analysis, NSRH surgery after NAC via balloon occluded arterial infusion brings beneficial results to patients with bulky IB2 to IIB cervical cancers.
本研究的目的是对一组接受保留神经的根治性子宫切除术（NSRH）且接受或未接受新辅助化疗（NAC）的巨大宫颈癌患者进行特征描述，比较手术结果和膀胱功能的保留情况，并比较预后。53例患者接受了无NAC的NSRH（A组），33例患者在NAC后接受了NSRH（B组）。关于预后因素，两组之间仅在淋巴结转移方面存在显著差异（15%对42%，P = 0.01）。此外，B组患者的膀胱功能在术后三个月改善到与术前水平相同的程度。这些数据与A组的结果相似。关于总生存率，A组的5年生存率为98.1%（95%置信区间（CI）87.8 - 99.7），B组为86.7%（95%CI 71.7 - 96.7）（P>0.1）。我们回顾性地确定了2009年5月至2016年11月在大阪医学院接受NSRH的86例宫颈癌患者。NAC通过球囊闭塞动脉灌注进行。我们提取了患者的病情分期、肿瘤体积、组织学亚型、出血量、尿动力学研究结果和术后并发症的数据。这些数据被分为两组——接受NAC的患者和未接受NAC的患者——然后进行比较。根据我们的分析，通过球囊闭塞动脉灌注进行NAC后行NSRH手术给巨大IB2至IIB期宫颈癌患者带来了有益的结果。
