Samlal R A, van der Velden J, Schilthuis M S, Ten Kate F J, Hart A A, Lammes F B
Department of Obstetrics and Gynecology, University of Amsterdam, The Netherlands.
Eur J Gynaecol Oncol. 1997;18(6):478-81.
The purpose of this retrospective study was to investigate whether diagnostic conization influenced surgical morbidity of a subsequent radical hysterectomy in patients with early cervical carcinoma. Furthermore, the impact of an irradical conization on nodal metastases and prognosis was analysed. Included were 271 patients with stage IB and IIA cervical carcinoma who underwent an Okabayashi radical hysterectomy between 1982 and 1991. There were 68 patients who underwent conization prior to radical hysterectomy. The conization-radical hysterectomy interval was approximately six weeks. Surgical morbidity in patients with a previous conization was not significantly different from that in patients without a previous conization. Survival was also not significantly different between these groups (95% vs. 91%, p = 0.23). Multivariate analysis showed that an irradical conization was not associated with an increased risk for nodal metastases or a poorer prognosis. We suggest that in early cervical carcinoma, a diagnostic conization does not adversely affect early morbidity of a following radical hysterectomy. An irradical conization does not seem to influence prognosis.
这项回顾性研究的目的是调查诊断性锥切术是否会影响早期宫颈癌患者后续根治性子宫切除术的手术并发症。此外，还分析了切缘阳性的锥切术对淋巴结转移和预后的影响。纳入的271例患者为1982年至1991年间接受冈林根治性子宫切除术的IB期和IIA期宫颈癌患者。其中68例患者在根治性子宫切除术前行锥切术。锥切术与根治性子宫切除术的间隔约为六周。既往行锥切术患者的手术并发症与未行锥切术患者无显著差异。两组患者的生存率也无显著差异（95%对91%，p = 0.23）。多因素分析显示，切缘阳性的锥切术与淋巴结转移风险增加或预后较差无关。我们认为，在早期宫颈癌中，诊断性锥切术不会对后续根治性子宫切除术的早期并发症产生不利影响。切缘阳性的锥切术似乎不会影响预后。
