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同期放化疗后辅助手术治疗 IIB-IIIB 期宫颈癌的临床结局观察。

Clinical outcomes observation in stage IIB-IIIB cervical cancer treated by adjuvant surgery following concurrent chemoradiotherapy.

机构信息

Department of Gynecology, The Affiliated Hospital of Qingdao University, Shandong, 266003, Qingdao, China.

Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, P. R. China.

出版信息

BMC Cancer. 2021 Apr 21;21(1):442. doi: 10.1186/s12885-021-08146-3.

DOI:10.1186/s12885-021-08146-3
PMID:33882876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8059156/
Abstract

BACKGROUND

To explore the feasibility of adjuvant surgery following concurrent chemoradiation therapy (CCRT) in stage IIB-IIIB (according to FIGO staging of 2009) cervical cancer and analyze risk factors of recurrence after surgery.

METHODS

Forty-nine patients diagnosed with stage IIB-IIIB cervical cancer were reviewed retrospectively. We investigated the risk factors of recurrence after surgery using Chi-squared Test and further analyzed multiple factors affecting postoperative recurrence using the multi-factor logistic regression. Furthermore, the correlation of surgery outcomes (including operation time, bleeding, and hospitalization date and surgery complications) with the time which carried out between CCRT and completion surgery was analyzed.

RESULTS

Tumor histology and residual tumor in the cervix were significantly associated with postoperative recurrence (P = 0.014 and P = 0.040, respectively). Logistic regression analysis demonstrated that the independent risk factors of postoperative recurrence were age and residual tumor in the cervix (P = 0.017 and P = 0.030, respectively). Complications (operation time, bleeding, hospitalization date) were compared between patients with an interval with radiotherapy less than 6 weeks and patients with an interval longer than 6 weeks. There were statistical differences in the amount of bleeding and postoperative complications between the two groups (P = 0.019 and P = 0.044, respectively).

CONCLUSION

CCRT combined with surgery for stage IIB-IIIB cervical cancer was feasible, reduced the rate of postoperative recurrence and surgery complications were tolerated.

摘要

背景

探讨同期放化疗(CCRT)后辅助手术治疗 IIB-IIIB 期(根据 2009 年 FIGO 分期)宫颈癌的可行性,并分析手术后复发的危险因素。

方法

回顾性分析 49 例 IIB-IIIB 期宫颈癌患者的临床资料。采用卡方检验分析手术后复发的危险因素,并采用多因素 logistic 回归进一步分析影响术后复发的多因素。此外,还分析了 CCRT 与完成手术之间的时间与手术结果(包括手术时间、出血量、住院时间和手术并发症)之间的相关性。

结果

肿瘤组织学和宫颈残留肿瘤与术后复发显著相关(P=0.014 和 P=0.040)。Logistic 回归分析表明,术后复发的独立危险因素是年龄和宫颈残留肿瘤(P=0.017 和 P=0.030)。比较放疗间隔<6 周和>6 周的患者的并发症(手术时间、出血量、住院时间)。两组间出血量和术后并发症存在统计学差异(P=0.019 和 P=0.044)。

结论

CCRT 联合手术治疗 IIB-IIIB 期宫颈癌是可行的,降低了术后复发率,且手术并发症可耐受。

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本文引用的文献

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Evaluation of Prognostic Factors for the Parotid Cancer Treated With Surgery and Postoperative Radiotherapy.手术联合术后放疗治疗腮腺癌的预后因素评估
Clin Exp Otorhinolaryngol. 2020 Feb;13(1):69-76. doi: 10.21053/ceo.2019.00388. Epub 2019 Sep 5.
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Surgical morbidity and oncologic results after concurrent chemoradiation therapy for advanced cervical cancer.晚期宫颈癌同步放化疗后的手术并发症及肿瘤学结果
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