Xiangya School of Public Health, Central South University, No. 238 Shang Ma Yuan Ling Road, Changsha, 410008, Hunan, China.
Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China.
Sci Rep. 2022 Aug 17;12(1):13994. doi: 10.1038/s41598-022-17733-8.
This study aims to explore the recurrence rate and overall survival for patients with cervical cancer after the first treatment and the related risk factors. A retrospective cohort study was conducted on cervical cancer patients enrolled in a cancer specialist hospital in Hunan Province, China from January 1992 to December 2005 and followed up until December 2010. Kaplan-Meier survival analysis was used to estimate the cumulative recurrence rate, and Cox proportional hazards model was utilized to identify risk factors associated with prognosis. A total of 4358 patients were enrolled with a median follow-up of 7.4 years (range 5-19 years), and 372 (8.5%) patients had cancer recurrence. The cumulative recurrence rate showed a rapid increase from 3.8% in the first year after discharge to 8.0% in the fifth year, and the recurrence rate remained relatively stable afterward reaching 9.7% and 10.8% in the 10th and the 15th year, respectively. The median time to recurrence was 15.5 months with an IQR of 5.5-40.0 months. The Cox regression showed that miscarriage, clinical stage, and treatment received were significantly associated with cervical cancer recurrence after adjustment for confounders. Patients with recurrence showed a significantly higher risk for mortality than those without recurrence (HR 2.79, 95% CI 2.42-3.22). This study depicted the long-term recurrence rate and survival after recurrence for patients with cervical cancer after the first treatment, and reported time to recurrence and risk factors related to recurrence. These findings may provide important evidence for designing targeted interventions for the treatment of cervical cancer.
本研究旨在探讨首次治疗后宫颈癌患者的复发率和总生存率及其相关危险因素。采用回顾性队列研究方法，纳入了 1992 年 1 月至 2005 年 12 月在湖南省某癌症专科医院接受治疗并随访至 2010 年 12 月的宫颈癌患者。采用 Kaplan-Meier 生存分析法估计累积复发率，采用 Cox 比例风险模型识别与预后相关的危险因素。共纳入 4358 例患者，中位随访时间为 7.4 年（5-19 年），372 例（8.5%）患者发生癌症复发。复发累积率在出院后第 1 年迅速上升至 3.8%，第 5 年达到 8.0%，此后相对稳定，在第 10 年和第 15 年分别达到 9.7%和 10.8%。复发中位时间为 15.5 个月（IQR：5.5-40.0 个月）。Cox 回归分析显示，流产史、临床分期和治疗方法与调整混杂因素后的宫颈癌复发显著相关。复发患者的死亡风险明显高于未复发患者（HR：2.79，95%CI：2.42-3.22）。本研究描述了首次治疗后宫颈癌患者的长期复发率和复发后的生存率，并报告了复发时间和与复发相关的危险因素。这些发现可能为宫颈癌的治疗提供重要的证据。
