Alonso-Espías María, Gorostidi Mikel, Gracia Myriam, García-Pineda Virginia, Diestro María Dolores, Siegrist Jaime, Hernández Alicia, Zapardiel Ignacio
Gynecologic Oncology Unit, La Paz University Hospital, 28046 Madrid, Spain.
Gynecologic Oncology Unit, Donostia University Hospital, 20014 San Sebastian, Spain.
J Pers Med. 2023 Oct 12;13(10):1486. doi: 10.3390/jpm13101486.
The benefit of adjuvant radiotherapy (RT) after radical hysterectomy in patients with cervical cancer remains controversial. The aim of this study was to determine adjuvant RT's impact on survival in accordance with Sedlis criteria. Patients with early-stage cervical cancer undergoing radical hysterectomy between 2005 and 2022 at a single tertiary care institution were included. A multivariate analysis was performed to determinate if RT was an independent prognostic factor for recurrence or death. We also analysed whether there was a statistically significant difference in overall survival (OS) between patients who met only one or two Sedlis criteria, depending on whether they received adjuvant RT or not. 121 patients were included in this retrospective study, of whom 48 (39.7%) received adjuvant RT due to the presence of unfavourable pathological findings. In multivariate analysis, RT was not found to be a statistically significant prognostic factor for OS ( = 0.584) or disease-free survival (DFS) ( = 0.559). When comparing patients who met one or two Sedlis criteria, there were no statistically significant differences in OS between RT and no adjuvant treatment in either group. Since the selection of patients with cervical cancer eligible for surgery is becoming more accurate, adjuvant RT might not be necessary for patients with intermediate risk factors.
宫颈癌患者根治性子宫切除术后辅助放疗(RT)的益处仍存在争议。本研究的目的是根据Sedlis标准确定辅助放疗对生存的影响。纳入了2005年至2022年期间在一家三级医疗机构接受根治性子宫切除术的早期宫颈癌患者。进行多因素分析以确定放疗是否是复发或死亡的独立预后因素。我们还分析了仅符合一项或两项Sedlis标准的患者,根据是否接受辅助放疗,其总生存期(OS)是否存在统计学显著差异。这项回顾性研究纳入了121例患者,其中48例(39.7%)因存在不利的病理结果而接受了辅助放疗。在多因素分析中,未发现放疗是OS(P = 0.584)或无病生存期(DFS)(P = 0.559)的统计学显著预后因素。在比较符合一项或两项Sedlis标准的患者时,两组中放疗组和未接受辅助治疗组的OS均无统计学显著差异。由于 eligible for surgery 应改为 eligible for radical hysterectomy 符合根治性子宫切除术条件的宫颈癌患者的选择越来越准确,对于具有中度风险因素的患者,辅助放疗可能并非必要。 (注:原文中 eligible for surgery 表述有误,这里按照纠正后的 eligible for radical hysterectomy 翻译并添加注释说明)