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早期宫颈腺癌与腺鳞癌患者根治性手术后及术后辅助放疗的结局与预后因素比较

Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy.

作者信息

Zhou Yuncan, Wang Weiping, Hu Ke, Zhang Fuquan

机构信息

Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Oct 4;13:7597-7605. doi: 10.2147/CMAR.S329614. eCollection 2021.

Abstract

PURPOSE

No consensus has been reached regarding the survival difference between cervical adenocarcinoma (ADC) and adenosquamous carcinoma (ASC) patients. The purpose of this study was to compare survival outcomes and prognostic factors between early-stage ADC and ASC patients.

PATIENTS AND METHODS

We retrospectively reviewed stage IB-IIA patients with ADC and ASC who underwent radical hysterectomy and postoperative radiotherapy between June 2012 and December 2017.

RESULTS

A total of 125 patients were enrolled in our study (97 with ADC and 28 with ASC). The median follow-up period was 53.4 months. Compared with ASC patients, patients with ADC tended to have a higher proportion of positive pelvic lymph nodes (7.1% and 26.8%, respectively; = 0.028). The most common site of distant metastasis was the lung, followed by the intestine and colon. The 5-year overall survival (OS), disease-free survival (DFS), pelvic control, and distant control rates for ADC and ASC patients were 83.6% and 92.0% ( = 0.349), 77.5% and 87.7% ( = 0.279), 81.8% and 96.2% ( = 0.121), and 88.3% and 87.7% ( = 0.948), respectively. Parametrial invasion was a prognostic factor for OS. Lymphovascular space involvement was a prognostic factor for DFS.

CONCLUSION

ADC patients were more likely to have positive pelvic lymph nodes than those with ASC. There was no significant difference in survival outcomes between patients with ADC and ASC.

摘要

目的

关于宫颈腺癌(ADC)和腺鳞癌(ASC)患者的生存差异尚未达成共识。本研究的目的是比较早期ADC和ASC患者的生存结局及预后因素。

患者与方法

我们回顾性分析了2012年6月至2017年12月期间接受根治性子宫切除术及术后放疗的IB-IIA期ADC和ASC患者。

结果

本研究共纳入125例患者(97例ADC患者和28例ASC患者)。中位随访期为53.4个月。与ASC患者相比,ADC患者盆腔淋巴结阳性比例往往更高(分别为7.1%和26.8%;P = 0.028)。远处转移最常见的部位是肺,其次是肠和结肠。ADC和ASC患者的5年总生存率(OS)、无病生存率(DFS)、盆腔控制率和远处控制率分别为83.6%和92.0%(P = 0.349)、77.5%和87.7%(P = 0.279)、81.8%和96.2%(P = 0.121)以及88.3%和87.7%(P = 0.948)。宫旁浸润是OS的预后因素。脉管间隙浸润是DFS的预后因素。

结论

与ASC患者相比,ADC患者盆腔淋巴结阳性的可能性更大。ADC和ASC患者的生存结局无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb10/8500504/4bbc2f3bbcd2/CMAR-13-7597-g0001.jpg

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