Ngan H Y, Obradovic D, Krauer F
Department of Obstetrics and Gynaecology, University Hospital of Geneva.
Eur J Surg Oncol. 1988 Jun;14(3):203-8.
Forty-five patients with carcinoma of the cervix stage Ib or IIa underwent primary radical surgery. The patho-histological examination of the surgical specimens showed, that pelvic lymph node metastases, tumour volume, depth of tumour invasion, lymphatic or vascular permeation and parametrial involvement were significant bad prognostic factors. The histological types of squamous cell carcinomas and local lymphoplasmocytic stromal reaction to the tumour had no statistical prognostic significance. A simple and objective method of assessing tumour volume is described. A 5-year actuarial survival rate for patients with metastatic pelvic lymph nodes (33% of the patients in this study) treated by surgery and additional postoperative external whole pelvis radiotherapy was 55%. This is significantly lower than the 86% 5-year actuarial survival rate of patients without pelvic lymph node metastases treated by surgery alone (P less than 0.05). The postoperative radiotherapy of carcinoma of the cervix with bad prognostic factors including pelvic lymph node metastases seems to improve local tumour control and perhaps survival in a subgroup of node negative tumours presenting other histopathological risk factors.
45例Ib期或IIa期宫颈癌患者接受了根治性手术。手术标本的病理组织学检查显示，盆腔淋巴结转移、肿瘤体积、肿瘤浸润深度、淋巴管或血管浸润以及宫旁组织受累是显著的不良预后因素。鳞状细胞癌的组织学类型以及肿瘤局部的淋巴浆细胞间质反应无统计学预后意义。本文描述了一种简单、客观的评估肿瘤体积的方法。接受手术及术后全盆腔外照射放疗的盆腔淋巴结转移患者（本研究中占患者总数的33%）的5年精算生存率为55%。这显著低于单纯接受手术治疗的无盆腔淋巴结转移患者86%的5年精算生存率（P<0.05）。对于具有包括盆腔淋巴结转移在内的不良预后因素的宫颈癌患者，术后放疗似乎可改善局部肿瘤控制，并且可能提高存在其他组织病理学危险因素的部分淋巴结阴性肿瘤患者的生存率。
