同期放化疗治疗局部晚期宫颈癌患者盆腔淋巴结状态的临床影响。

Clinical Impact of Pelvic Lymph Node Status in Locally Advanced Cervical Cancer Patients Treated by Concurrent Chemoradiation Therapy.

机构信息

Radiation Oncology Unit, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand.

Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand.

出版信息

Asian Pac J Cancer Prev. 2021 Feb 1;22(2):491-497. doi: 10.31557/APJCP.2021.22.2.491.

DOI:10.31557/APJCP.2021.22.2.491

PMID:33639665

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8190339/

Abstract

OBJECTIVE

To explore the treatment outcomes of locally advanced cervical cancer (LACC) patients with pelvic lymph node enlargement (PLNE) or stage IIIC1 when compared with no PLNE and unknown PLN status (UNK).

MATERIALS AND METHODS

Retrospective cohort study was designed by matching with the ratio of 1:4:4 for patients with PLNE, no PLNE and UNK between 2003 and 2017. The main factor which was used to match was clinical staging.

RESULTS

All 360 LACC patients who treated as concurrent chemoradiation therapy (CCRT) were composed of 40 with PLNE, 160 with no PLNE and 160 with UNK. The majority of tumor histology (78.9%) was squamous cell carcinoma and 51.1% were diagnosed in stage IIB. Five-year progression free survival rates of patients with PLNE, no PLNE and UNK were 42.7%, 64.5% and 59.0%, respectively (P = 0.191), and corresponding with 5-year overall survival rates of 57.0%, 66.0% and 61.9% (P = 0.608). Patients with PLNE had local recurrence (LR) at 22.5%, compared with no PLNE at 11.3% and UNK at 11.9%. The most common site of LR for patients with PLNE was PLN with odds ratio of 19.7 when using no PLNE as reference (P < 0.001). There was no statistically significant difference between distant metastasis rates in PLN statuses of patients with PLNE, no PLNE and UNK at 20.6%, 30.0% and 26.3%, respectively. Conclusions: LACC patients with PLNE had a trend of poorer survival rates than patients with no PLNE, while treatment outcomes of patients with UNK were not inferior to no PLNE.
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摘要

目的

探讨局部晚期宫颈癌（LACC）患者盆腔淋巴结肿大（PLNE）或 IIIC1 期与无 PLNE 和未知 PLN 状态（UNK）患者的治疗结果。

材料与方法

采用 1:4:4 比例的病例对照研究，对 2003 年至 2017 年间 PLNE、无 PLNE 和 UNK 的患者进行匹配。主要匹配因素为临床分期。

结果

360 例接受同期放化疗（CCRT）的 LACC 患者中，PLNE 组 40 例，无 PLNE 组 160 例，UNK 组 160 例。肿瘤组织学类型以鳞癌为主（78.9%），ⅡB 期占 51.1%。PLNE、无 PLNE 和 UNK 患者的 5 年无进展生存率分别为 42.7%、64.5%和 59.0%（P = 0.191），相应的 5 年总生存率分别为 57.0%、66.0%和 61.9%（P = 0.608）。PLNE 组局部复发率（LR）为 22.5%，无 PLNE 组为 11.3%，UNK 组为 11.9%。PLNE 患者 LR 最常见的部位是 PLN，与无 PLNE 相比，比值比为 19.7（P < 0.001）。PLNE、无 PLNE 和 UNK 患者的远处转移率分别为 20.6%、30.0%和 26.3%，差异无统计学意义。