Thoms W W, Unger E R, Carisio R, Nisenbaum R, Spann C O, Horowitz I R, Reeves W C
Department of Radiation Oncology, Emory University School of Medicine, Marietta, GA 30060, USA.
J Natl Med Assoc. 1998 May;90(5):303-8.
This study reviewed a high-risk population of inner-city women with FIGO (International Federation of Gynecologists and Obstetricians) stage Ib cervical cancer diagnosed and treated at a single institution between 1986 and 1993. The patient age at diagnosis averaged 49 years, and most of the patients were black (83%). Squamous carcinomas predominated (75%). Radiotherapy was the most frequent treatment modality (49%), followed by surgery (38%) and combined radiation/surgery (13%). The Kaplan-Meier estimated 4-year survival for all patients completing treatment was 81%. Increased survival was significantly associated with therapy. The Kaplan-Meier estimated survival at 26 months (the time of the last death in radiotherapy patients) was 66% for radiotherapy patients and 100% for those treated with surgery. Radiotherapy patients differed from surgery patients in age, tumor size, and pelvic lymph node status, indicating that treatment selection bias could explain the observed difference in survival. Age, race, histology, and cervical lesion size were not significantly associated with survival.
本研究回顾了1986年至1993年间在单一机构诊断和治疗的患有国际妇产科联盟（FIGO）Ib期宫颈癌的市中心高危女性人群。诊断时患者的平均年龄为49岁，大多数患者为黑人（83%）。鳞状细胞癌占主导（75%）。放疗是最常用的治疗方式（49%），其次是手术（38%）和放疗/手术联合治疗（13%）。所有完成治疗的患者的Kaplan-Meier估计4年生存率为81%。生存率的提高与治疗显著相关。放疗患者在26个月（放疗患者最后一例死亡时间）的Kaplan-Meier估计生存率为66%，手术治疗患者为100%。放疗患者与手术患者在年龄、肿瘤大小和盆腔淋巴结状态方面存在差异，这表明治疗选择偏倚可以解释观察到的生存差异。年龄、种族、组织学类型和宫颈病变大小与生存率无显著相关性。
