Imaizumi E, Nagata I, Furuya K, Kato K
Department of Obstetrics and Gynecology, National Defense Medical College, Saitama.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Dec;40(12):1805-10.
One hundred and sixty cases of cervical carcinoma have been treated surgically for the last 8 years. The numbers of cases of stage 0, 1a, 1b, 2a, 2b, 3 and 4 were 55, 14, 45, 15, 16, 10 and 1, respectively. Simple or extended hysterectomy without lymphadenectomy was performed for stage 0 and 1a cases, radical hysterectomy for stage 1b, 2a and 2b cases, and staging laparotomy for stage 3 and 4 cases. Before July, 1976, postoperative irradiation had been applied only for stage 1b, 2a, 2b cases with evidence of histological lymph node metastasis. Since two cases of vaginal stump recurrence were encountered during this period, irradiation was performed for all cases with a tumor size greater than 1cm in diameter, or with infiltration reaching half of the cervical wall thereafter. Three year comulative survival rates (3YCSR) for stage 0, 1a, 1b, 2a, 2b, 3a and 3b groups were 100%, 90%, 90.6%, 84.6%, 79.5%, 60% and 55.5%, respectively. In stage 1b group, there was a significant difference (p less than 0.05) in the 3YCSR between the cases with lymph node involvement (65.6%) and without it (96.2%). There was no significant difference in the factors indicating postoperative outcomes (the period for recovery of urinary functions, the incidence of ileus and the fever index) between the cases with and without pelvic peritonealization at the time of radical hysterectomy.
在过去8年中，对160例宫颈癌患者进行了手术治疗。0期、1a期、1b期、2a期、2b期、3期和4期的病例数分别为55例、14例、45例、15例、16例、10例和1例。0期和1a期病例行单纯或扩大子宫切除术，不做淋巴结清扫；1b期、2a期和2b期病例行根治性子宫切除术；3期和4期病例行分期剖腹术。1976年7月以前，术后放疗仅用于有组织学证实淋巴结转移的1b期、2a期、2b期病例。由于在此期间遇到2例阴道残端复发，此后对所有肿瘤直径大于1cm或浸润达宫颈壁一半的病例均进行放疗。0期、1a期、1b期、2a期、2b期、3a期和3b期组的3年累积生存率分别为100%、90%、90.6%、84.6%、79.5%、60%和55.5%。在1b期组中，有淋巴结转移的病例（65.6%）和无淋巴结转移的病例（96.2%）的3年累积生存率有显著差异（p<0.05）。根治性子宫切除时有无盆腔腹膜化的病例在提示术后结局的因素（排尿功能恢复时间、肠梗阻发生率和发热指数）方面无显著差异。
