Gynecologic Oncology Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital , Ankara, Turkey.
Gynecology and Obstetrics Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2021 Nov;266:126-132. doi: 10.1016/j.ejogrb.2021.09.028. Epub 2021 Sep 28.
To define the relationship of tumor size with surgico-pathological factors and oncological outcome in FIGO 2014 stage IB cervical cancer.
This study retrospectively evaluated 384 FIGO 2014 Stage IB cervical cancer patients who underwent radical hysterectomy and lymphadenectomy. Tumor size was stratified according to 2 cm (≤ 2cm, 2-≤4 cm, >4 cm) and 4 cm (≤4 cm, >4 cm), and the relationship with poor prognostic factors, and the effects on survival were examined. The distribution of prognostic factors was compared between three subgroups: ≤2 cm vs. 2-≤4 cm; 2-≤4 cm vs. > 4 cm and ≤ 2 cm vs. > 4 cm. Survival rate was evaluated using the Kaplan-Meier method and compared with the log-rank test. Multivariate analysis was performed using Cox proportional-hazards regression.
Stratification of tumor size according to 4 cm was found to better determine pelvic lymph node determination. Parametrial involvement, uterine involvement and deep cervical stromal invasion were correlated with increasing tumor size. Lymph node involvement and uterine involvement were an independent prognostic risk factor for recurrence and cancer-specific survival. Tumor size showed no association with prognosis.
There is no meaningful cut-off value for tumor size determining all surgico-pathological factors. There was also seen to be no association between tumor size and recurrence or disease-related mortality.
定义肿瘤大小与 FIGO 2014 分期 IB 宫颈癌的手术病理因素和肿瘤学结局的关系。
本研究回顾性评估了 384 例接受根治性子宫切除术和淋巴结切除术的 FIGO 2014 分期 IB 宫颈癌患者。根据 2cm（≤2cm、2-≤4cm、>4cm）和 4cm（≤4cm、>4cm）将肿瘤大小分层，并检查与不良预后因素的关系及其对生存的影响。在≤2cm 与 2-≤4cm、2-≤4cm 与>4cm 以及≤2cm 与>4cm 这三个亚组之间比较了预后因素的分布。使用 Kaplan-Meier 方法评估生存率，并使用对数秩检验进行比较。使用 Cox 比例风险回归进行多变量分析。
根据 4cm 对肿瘤大小进行分层，发现可以更好地确定盆腔淋巴结的情况。旁膜浸润、子宫浸润和宫颈深层间质浸润与肿瘤大小的增加相关。淋巴结浸润和子宫浸润是复发和癌症特异性生存的独立预后危险因素。肿瘤大小与预后无关。
肿瘤大小没有确定所有手术病理因素的有意义的截止值。肿瘤大小与复发或疾病相关死亡率之间也没有关联。
