Chen Yuanyuan, Zhu Yiming, Wu Jinchang
Department of Radiation, The Affiliated Suzhou Hospital of Nanjing Medical University and Second Affiliated Hospital of Xuzhou Medical University, Suzhou, Jiangsu, People's Republic of China.
Department of Radiation, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Cancer Manag Res. 2021 Oct 28;13:8131-8136. doi: 10.2147/CMAR.S314384. eCollection 2021.
Patterns of recurrence in cervical cancer may be useful as prognostic indicators. The aim of the present study was to determine the value of patterns of recurrence for predicting prognosis of early-stage cervical cancer.
Of the 1934 patients diagnosed with primary cervical cancer between August 2008 and July 2013, 167 experienced recurrence after radical hysterectomy, including pelvic lymphadenectomy, and adjuvant postoperative treatment. The patterns of recurrence were classified into four groups: central, pelvic, distant only, and combined metastases, and the relationship between patterns of recurrence and prognosis was evaluated.
The patterns of lung only (21.6%), central (21.0%), and pelvic recurrence (17.4%) were the most common sites, followed by distant lymph nodes and lung with other sites. The longest 5-year survival period occurred in patients with central recurrence (70.5%), followed by distant lymph nodes (58.4%), peritoneum (58.3%), and lung only (36.8%). Late recurrence was detected in 28 patients (1.4%), who showed a better prognosis than those with early recurrence (p = 0.003).
The patterns of recurrence help to predict prognosis. A central pattern of recurrence, distant lymph node recurrence, and peritoneal recurrence were associated with favorable outcomes after salvage therapy; however, patients who suffered other recurrent patterns, along with early recurrence, require more effective therapeutic strategies to improve survival.
宫颈癌的复发模式可能作为预后指标。本研究的目的是确定复发模式对预测早期宫颈癌预后的价值。
在2008年8月至2013年7月期间诊断为原发性宫颈癌的1934例患者中，167例在根治性子宫切除术后复发，包括盆腔淋巴结清扫术及术后辅助治疗。复发模式分为四组：中心型、盆腔型、仅远处转移型和混合型转移，评估复发模式与预后之间的关系。
仅肺部复发（21.6%）、中心型复发（21.0%）和盆腔复发（17.4%）是最常见的部位，其次是远处淋巴结及肺部合并其他部位复发。中心型复发患者的5年生存期最长（70.5%），其次是远处淋巴结复发（58.4%）、腹膜复发（58.3%）和仅肺部复发（36.8%）。28例患者（1.4%）出现晚期复发，其预后优于早期复发患者（p = 0.003）。
复发模式有助于预测预后。中心型复发模式、远处淋巴结复发和腹膜复发与挽救治疗后的良好结局相关；然而，出现其他复发模式以及早期复发的患者需要更有效的治疗策略来提高生存率。
