Artman L E, Hoskins W J, Bibro M C, Heller P B, Weiser E B, Barnhill D R, Park R C
Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-5011.
Gynecol Oncol. 1987 Sep;28(1):8-13. doi: 10.1016/s0090-8258(87)80002-1.
From September 1971 through December 1982, 153 patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and pelvic lymphadenectomy at two of the teaching hospitals of the Uniformed Services University of the Health Sciences. Records were retrospectively analyzed and independent pathologic review was performed. All surgical procedures were performed by fellows or senior residents under the direct supervision of the gynecologic oncology staff of the Walter Reed Army Medical Center or the Naval Hospital, Bethesda, Maryland. In this series, IB carcinoma was defined as squamous carcinoma clinically confined to the cervix with invasion greater than 5 mm from the basement membrane or any adenocarcinoma confined to the cervix. The average age of the patients was 38.3 years. The histologic types were squamous in 72%, adenocarcinoma in 16%, and adenosquamous in 10.5%. The mean operating time was 5 hr and 40 min with an average blood loss of 1800 cc. There were two ureterovaginal and two vesicovaginal fistulae for an overall fistula rate of 2.6%. Actuarial survival for these 153 patients is 84%. This extends the previous series of R. C. Park, W. E. Patow, R. E. Rogers, and E. A. Zimmerman, Obstet. Gynecol. 41, 117-122 (1973) of 122 cases collected from 1961 to September 1971 to 275 cases. In comparing the two time periods, no significant differences were found in operative technique or complications, but there was a change in the incidence of adenocarcinoma and mixed cell types and a difference in survival. A relatively higher incidence of more aggressive tumors may indicate the need for different therapeutic approaches in the future.
1971年9月至1982年12月期间，153例IB期宫颈癌患者在美国军医大学的两所教学医院接受了根治性子宫切除术和盆腔淋巴结清扫术。对病历进行了回顾性分析，并进行了独立的病理检查。所有手术均由研究员或高级住院医师在沃尔特·里德陆军医疗中心或马里兰州贝塞斯达海军医院的妇科肿瘤学工作人员的直接监督下进行。在本系列中，IB期癌定义为临床局限于宫颈的鳞状癌，浸润深度超过基底膜5mm，或任何局限于宫颈的腺癌。患者的平均年龄为38.3岁。组织学类型为鳞状癌占72%，腺癌占16%，腺鳞癌占10.5%。平均手术时间为5小时40分钟，平均失血量为1800cc。有2例输尿管阴道瘘和2例膀胱阴道瘘，总瘘管发生率为2.6%。这153例患者的精算生存率为84%。这将R.C.帕克、W.E.帕托、R.E.罗杰斯和E.A.齐默尔曼之前在《妇产科学》第41卷第117 - 122页（1973年）报道的1961年至1971年9月收集的122例病例系列扩展至275例。在比较这两个时间段时，手术技术或并发症方面未发现显著差异，但腺癌和混合细胞类型的发生率有所变化，生存率也有所不同。侵袭性较强肿瘤的相对较高发生率可能表明未来需要不同的治疗方法。
