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根治性子宫切除术联合辅助放化疗对 FIGO 分期 IIIC1 期宫颈腺癌患者生存的影响。

Survival impact of adjuvant concurrent chemoradiotherapy after radical hysterectomy in FIGO stage IIIC1 cervical adenocarcinoma.

机构信息

Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.

出版信息

Int J Clin Oncol. 2021 Jul;26(7):1322-1329. doi: 10.1007/s10147-021-01904-0. Epub 2021 Apr 6.

Abstract

BACKGROUND

We evaluated the survival effect of adjuvant concurrent chemoradiotherapy after radical hysterectomy in patients with clinical pelvic node-positive cervical adenocarcinoma.

METHODS

Patients with pelvic node-positive cervical adenocarcinoma diagnosed between 2000 and 2016 at our institution were identified. Survival was compared between patients who underwent radical hysterectomy alone and those who received concurrent chemoradiotherapy as an adjuvant treatment. Survival analysis using log-rank test and Cox proportional hazards model was performed.

RESULTS

We identified 80 patients who underwent radical hysterectomy for clinical pelvic node-positive cervical adenocarcinoma; of these, four with pathological pelvic node-negative adenocarcinoma were excluded. Of the 76 patients, 27 underwent radical hysterectomy alone and 49 received radical hysterectomy followed by concurrent chemoradiotherapy. With a median follow-up of 53 months, the 5-year overall survival rate was 51.0% in patients who underwent radical hysterectomy alone versus 53.0% in patients who received additional concurrent chemoradiotherapy (log-rank p = 0.455).

CONCLUSION

The addition of concurrent chemoradiotherapy after radical hysterectomy did not significantly improve survival among patients with pelvic node-positive cervical adenocarcinoma. More appropriate treatment strategies are needed to improve the survival outcomes of these patients.

摘要

背景

我们评估了根治性子宫切除术后辅助同步放化疗对临床盆腔淋巴结阳性宫颈腺癌患者的生存影响。

方法

我们在本院确定了 2000 年至 2016 年间诊断为盆腔淋巴结阳性宫颈腺癌的患者。比较了单纯根治性子宫切除术和接受同步放化疗作为辅助治疗的患者的生存情况。使用对数秩检验和 Cox 比例风险模型进行生存分析。

结果

我们确定了 80 例因临床盆腔淋巴结阳性宫颈腺癌接受根治性子宫切除术的患者;其中 4 例病理盆腔淋巴结阴性腺癌患者被排除。在 76 例患者中,27 例患者仅接受根治性子宫切除术,49 例患者接受根治性子宫切除术加同步放化疗。中位随访 53 个月后,单纯根治性子宫切除术组患者的 5 年总生存率为 51.0%,而接受额外同步放化疗组的患者为 53.0%(对数秩检验 p=0.455)。

结论

根治性子宫切除术后加用同步放化疗并未显著改善盆腔淋巴结阳性宫颈腺癌患者的生存。需要制定更合适的治疗策略来改善这些患者的生存结果。

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