Zhu Hui-Ting, Yan Wen-Juan, Gao Yu-Hua
Department of Gynecology, Liaoning Cancer Hospital & Institute, Cancer Hospital Of China Medical University, Shenyang, China.
Department of General Surgery, General Hospital of Eastern Theater Command, People's Liberation Army (PLA), Nanjing, China.
Front Oncol. 2022 Jan 21;11:782403. doi: 10.3389/fonc.2021.782403. eCollection 2021.
To investigate the recurrence patterns and prognostic factors of patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) followed by adjuvant radiotherapy (RT)/concurrent chemoradiotherapy (CCRT).
The medical records of 153 patients with pre-operative International Federation of Gynecology and Obstetrics stage IB-IIA cervical cancer, who were treated with RHND followed by adjuvant RT/CCRT at the Liaoning Cancer Hospital between January 1, 2012 and May 31, 2018, were retrospectively analyzed.
The median disease progression-free survival time was 16 months, and 75.2% (115/153) of patients had a relapse within two years. The survival of patients with multi-site relapse was significantly lower in comparison to those with relapse in a single site (p < 0.001). The survival rate of patients with distant metastasis (DM) and combined recurrence (DM with localregional recurrence [LR]) was significantly lower than that of patients with only LR (p = 0.006, p < 0.001). Furthermore, the survival rate of patients with combined recurrence was significantly lower than that of patients with only DM (p = 0.046). Multivariate analysis showed that resection margin involvement, para-aortic and common iliac lymph node metastasis, DM, no treatment after disease relapse, and early disease relapse were independent prognostic factors associated with poor survival.
Most of the cervical cancer patients who received initial RHND followed by adjuvant RT/CCRT had a relapse within two years. Resection margin involvement, para-aortic and common iliac lymph node metastasis, DM, no treatment after recurrence, and early disease relapse were found to be prognostic factors in patients with recurrent cervical cancer after RHND followed by adjuvant RT/CCRT.
探讨根治性子宫切除术加淋巴结清扫术（RHND）后辅助放疗（RT）/同步放化疗（CCRT）的复发性宫颈癌患者的复发模式和预后因素。
回顾性分析2012年1月1日至2018年5月31日在辽宁省肿瘤医院接受RHND后辅助RT/CCRT治疗的153例术前国际妇产科联盟（FIGO）分期为IB-IIA期宫颈癌患者的病历。
疾病无进展生存时间的中位数为16个月，75.2%（115/153）的患者在两年内复发。多部位复发患者的生存率明显低于单部位复发患者（p<0.001）。远处转移（DM）和合并复发（DM合并局部区域复发[LR]）患者的生存率明显低于仅LR患者（p=0.006，p<0.001）。此外，合并复发患者的生存率明显低于仅DM患者（p=0.046）。多因素分析显示，切缘受累、腹主动脉旁和髂总淋巴结转移、DM、疾病复发后未治疗以及早期疾病复发是与生存不良相关的独立预后因素。
大多数接受初始RHND后辅助RT/CCRT的宫颈癌患者在两年内复发。切缘受累、腹主动脉旁和髂总淋巴结转移、DM、复发后未治疗以及早期疾病复发被发现是RHND后辅助RT/CCRT的复发性宫颈癌患者的预后因素。
