El-Senoussi M, Bakri Y, Amer M H, DeVol E B
Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Int J Radiat Oncol Biol Phys. 1998 Aug 1;42(1):91-100. doi: 10.1016/s0360-3016(98)00166-7.
Earlier stages cervical cancer has been customarily treated with radiation therapy, surgery, or combination thereof. We present our experience in the management of stage-I and -II patients in a major cancer center in the Kingdom of Saudi Arabia.
Between 1979 and 1991, 164 patients were treated and closely followed at a tertiary care medical center.
Patients accounted for 0.78 % of all cancer patient referral. More cases with earlier stages (41.3 %) were referred since 1986, compared to a lower referral (26.1%) during the earlier part of the study (p=0.027). Age ranged from 21 to 80 years with a median of 46.5 years. Clinical stages at presentation included Stage-IA (3.0%), IB (28.7%), IIA (11.6%), and IIB (56.7%). Majority (87.2%) had squamous cell carcinoma, while the rest, had adenocarcinoma (9.1%) or other malignancies (3.6%). Among the 143 patients with squamous cell cancer, eighteen had attempted radical resection, 101 were treated with radiation, and 24 had both modalities. For squamous cancer patients, fifty-one (35.7%) had disease relapse either locally (19 cases), distally (23 patients) or both combined (9 patients). The pattern of failure was unrelated to stage of disease, histological diagnosis or the mode of therapy initially administered. The cumulative five and ten year's survival for squamous cancer patients was 68.3% and 57.9% respectively. Better survival was noted for patients with smaller sized tumors, free parametrium, and Stage-I disease. When all factors were considered in the regression model, only the status of parametrial involvement was found to be of significance.
Cervical cancer is relatively rare in Saudi Arabia. With the improvement in health care delivery, more patients were lately seen at earlier stages of disease. With radiation therapy, two thirds of patients survived five years. The extent of parametrial involvement was the best predictor for long term survival.
早期宫颈癌通常采用放射治疗、手术或两者联合治疗。我们介绍了在沙特阿拉伯王国一家主要癌症中心对I期和II期患者的治疗经验。
1979年至1991年间，164例患者在一家三级医疗中心接受治疗并密切随访。
患者占所有癌症患者转诊的0.78%。自1986年以来，更多早期病例（41.3%）被转诊，而在研究早期转诊率较低（26.1%）（p = 0.027）。年龄范围为21至80岁，中位数为46.5岁。就诊时的临床分期包括IA期（3.0%）、IB期（28.7%）、IIA期（11.6%）和IIB期（56.7%）。大多数（87.2%）为鳞状细胞癌，其余为腺癌（9.1%）或其他恶性肿瘤（3.6%）。在143例鳞状细胞癌患者中，18例尝试根治性切除，101例接受放射治疗，24例接受了两种治疗方式。对于鳞状细胞癌患者，51例（35.7%）出现疾病复发，包括局部复发（19例）、远处复发（23例）或两者皆有（9例）。失败模式与疾病分期、组织学诊断或最初采用的治疗方式无关。鳞状细胞癌患者的累积五年和十年生存率分别为68.3%和57.9%。肿瘤较小、宫旁组织未受累和I期疾病患者的生存率更高。在回归模型中考虑所有因素时，仅发现宫旁组织受累情况具有显著性。
宫颈癌在沙特阿拉伯相对罕见。随着医疗保健服务的改善，最近更多患者在疾病早期被发现。采用放射治疗，三分之二的患者存活了五年。宫旁组织受累程度是长期生存的最佳预测指标。
