子宫颈癌术后规范化治疗对肿瘤学预后影响研究  

Effect of standardization of postoperative adjuvant therapy on oncology outcome in patients with cervical cancer

作　　者：尹钊红 黎志强[1] 康山 杨鹰 郭建新 詹雪梅[5] 李朋飞 刘佳琪 郎景和 刘萍[1] 陈春林[1] YIN Zhao-hong;LI Zhi-qiang;KANG Shan;YANG Ying;GUO Jian-xin;ZHAN Xue-mei;LI Peng-fei;LIU Jia-qi;LANG Jing-he;LIU Ping;CHEN Chun-lin(Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;不详)

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515 [2]河北医科大学第四医院妇科,河北石家庄050000 [3]陆军军医大学新桥医院妇产科,重庆400037 [4]解放军陆军特色医学中心(大坪医院)妇产科,重庆400042 [5]江门市中心医院妇科,广东江门529030 [6]中国医学科学院北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2022年第1期101-104,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：十二五国家科技支撑计划(2014BAI05B03);国家自然科学基金(81272585);广州市科技计划(158100075);广东省教育厅高水平大学建设经费南方医科大学临床研究启动项目(LC2016ZD019)。

摘　　要：目的探讨国际妇产科联盟(FIGO)2018分期ⅠA~ⅡA期子宫颈癌患者术后辅助治疗的规范性对肿瘤学结局的影响。方法在中国子宫颈癌临床诊疗项目大数据库中筛选FIGO 2018ⅠA~ⅡA期接受规范手术治疗的子宫颈癌患者,比较术后治疗规范与术后治疗不规范患者的5年总体生存率(OS)和无瘤生存率(DFS)。结果(1)纳入符合入组标准的FIGO 2018ⅠA~ⅡA期接受规范手术治疗5638例(包括术后治疗规范2205例,术后治疗不规范3433例),中位随访时间44个月(术后治疗规范组43个月,术后治疗不规范组46个月)。(2)Kaplan-Meier生存分析显示,术后治疗规范组肿瘤学结局明显优于术后治疗不规范组(OS:95.7%vs.88.7%,P<0.001;DFS:92.1%vs.83.4%,P<0.001)。(3)Cox多因素分析显示,术后治疗不规范组发生死亡的风险是术后治疗规范组的1.556倍(HR=1.556,95%CI 1.135~2.133,P=0.006),发生复发/死亡的风险是术后治疗规范组的1.391倍(HR=1.391,95%CI1.113~1.737,P=0.004)。结论从肿瘤学预后分析,术后治疗规范患者肿瘤学结局优于术后治疗不规范者,故术后治疗规范性需要得到重视。Objective To explore the effect of standardization of postoperative adjuvant therapy on oncology outcome in patients with FIGO 2018 stage I A-II A cervical cancer.Methods Patients with cervical cancer in the new stage I AII A of FIGO 2018 were selected from Four C Database.The 5-year OS and DFS of patients with standardized and nonstandardized postoperative treatments were compared.Results(1)Totally 5638 patients with cervical cancer were in FIGO 2018 stageⅠA-ⅡA enrolled(standardized postoperative treatment 2205,non-standardized postoperative treatment 3433).The median follow-up period was 44 months(standardized postoperative treatment 43 months,nonstandardized postoperative treatment 46 months).(2)Kaplan-Meier survival analysis showed that the oncology outcome of the standardized postoperative treatment group was significantly better than that of the non-standardized postoperative treatment group(OS:95.7%vs.88.7%,P<0.001;DFS:92.1%vs.83.4%,P<0.001).(3)Cox multivariate analysis showed that the risk of death in the non-standardized postoperative treatment group was 1.556 times higher than that in the standardized postoperative treatment group(HR=1.556,95%CI 1.135-2.133,P=0.006),and the risk of recurrence/death was 1.391 times higher(HR=1.391,95%CI 1.113-1.737,P=0.004).Conclusion From the perspective of oncology outcome,the oncology outcome of the standardized postoperative treatment group is better than that of the non-standardized postoperative treatment group.The standardization of postoperative treatment needs to be paid attention to.

关 键 词：子宫颈癌 术后治疗 规范性 肿瘤学结局 

分 类 号：R737.3[医药卫生—肿瘤]