Guo Huimin, Gao Songkun, Kong Weimin
Gynecology Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
Gynecologic Oncology Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
Int J Womens Health. 2024 Apr 4;16:579-590. doi: 10.2147/IJWH.S446644. eCollection 2024.
In current most observational studies, the prognosis of cervical adenocarcinoma is worse than that of cervical squamous cell carcinoma. However, most of the current studies are holistic and lack more detailed staging and grouping analysis of the prognosis of the two types of cervical tumors.
Inclusion from the SEER database of stage IIB-IVA cervical squamous cell carcinoma and cervical adenocarcinoma patients who did not undergo surgery from 2000 to 2019, underwent radiotherapy/chemotherapy/radiotherapy and chemotherapy/no treatment, and then propensity score matching (PSM) was performed to eliminate confounding factors between cervical squamous cell carcinoma and cervical adenocarcinoma patients with the same stage and treatment method. After matching the original data and propensity score, logarithmic rank test and chi square test were used to evaluate the survival benefits of different stages and treatment methods for patients using Kaplan Meier curve. The prognosis of two types of cervical tumors under the same treatment method was compared, and factors that may cause poor prognosis were analyzed, excluding confounding factors.
A total of 10,057 patients were included in this study, and survival analysis showed a significant correlation between the treatment method used and patient prognosis (P<0.05). However, for patients who received radiotherapy or no special treatment, OS and CSS were only related to tumor stage and not to tumor type. In patients undergoing radiotherapy and chemotherapy, the OS and CSS of stage IIIA and IVA patients are not related to tumor pathological characteristics, while the OS of stage IIB patients is not related to tumor properties after PSM.
In patients undergoing radiotherapy and chemotherapy, the OS and CSS of stage IIIA and IVA patients were not related to histological type, while the OS of stage IIB patients was not related to histological type after PSM.
在当前大多数观察性研究中，宫颈腺癌的预后比宫颈鳞状细胞癌差。然而，目前大多数研究都是整体性的，缺乏对这两种类型宫颈肿瘤预后更详细的分期和分组分析。
纳入SEER数据库中2000年至2019年未接受手术、接受放疗/化疗/放疗和化疗/未治疗的IIB-IVA期宫颈鳞状细胞癌和宫颈腺癌患者，然后进行倾向得分匹配（PSM）以消除相同分期和治疗方法的宫颈鳞状细胞癌和宫颈腺癌患者之间的混杂因素。在对原始数据和倾向得分进行匹配后，使用对数秩检验和卡方检验，通过Kaplan Meier曲线评估不同分期和治疗方法对患者的生存获益。比较相同治疗方法下两种类型宫颈肿瘤的预后，并分析可能导致预后不良的因素，排除混杂因素。
本研究共纳入10057例患者，生存分析显示所用治疗方法与患者预后之间存在显著相关性（P<0.05）。然而，对于接受放疗或未接受特殊治疗的患者，总生存期（OS）和癌症特异性生存期（CSS）仅与肿瘤分期有关，而与肿瘤类型无关。在接受放疗和化疗的患者中，IIIA期和IVA期患者的OS和CSS与肿瘤病理特征无关，而IIB期患者在PSM后的OS与肿瘤性质无关。
在接受放疗和化疗的患者中，IIIA期和IVA期患者的OS和CSS与组织学类型无关，而IIB期患者在PSM后的OS与组织学类型无关。
