早期子宫颈癌术后复发的不同治疗方法的肿瘤学结局:一项多中心回顾性研究  

The oncological outcomes of different treatment methods for the recurrence of early cervical cancer after radical hysterectomy:a multi⁃center retrospective study

作　　者：刘江豪 姜文轩 刘萍[1] 陆安伟 何俊燊 宾晓农 郎景和[4] 陈春林[1] LIU Jiang-hao;JIANG Wen-xuan;LIU Ping;LU An-wei;HE Jun-shen;BIN Xiao-nong;LANG Jing-he;CHEN Chun-lin(不详;Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical Univsity,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院妇产科,广州510515 [2]南方医科大学深圳医院 [3]广州医科大学公共卫生学院 [4]北京协和医院妇产科

出　　处：《妇产与遗传（电子版）》2023年第1期7-12,共6页Obstetrics-Gynecology and Genetics (Electronic Edition)

基　　金：十二五国家科技支撑计划(2014BAI05B03);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：目的比较不同治疗方法治疗早期子宫颈癌广泛性子宫切除术后复发患者的肿瘤学结局差异。方法基于中国子宫颈癌临床诊疗大数据库,筛选纳入早期子宫颈癌根治术后复发患者,根据转移部位分为单纯盆腔转移组、远处转移组及盆腔转移合并远处转移组,再比较不同治疗方法,如放疗、单纯化疗或手术综合治疗的肿瘤学结局。结果①从数据库63926例子宫颈癌患者中,共纳入893例广泛性子宫切除术后复发患者,其中单纯盆腔转移组共398例,远处转移组共190例,盆腔转移和远处转移组共305例。②其中单纯盆腔转移398例,放疗组(n=248)5年总生存期高于单纯化疗组(n=93)(61.90%vs 44.40%,χ^(2)=15.292,P<0.001),手术综合治疗组(n=57)5年总生存期高于单纯化疗组(68.50%vs 44.40%,χ^(2)=6.089,P=0.014),但放疗组和手术综合治疗组5年总生存期比较差异无统计学意义(61.90%vs 68.50%,χ^(2)=0.244,P=0.621)。③远处转移190例,其中放疗组(n=67)、单纯化疗组(n=92)及手术综合治疗组(n=31)的5年总生存期比较差异无统计学意义(51.50%vs 59.20%vs 53.50%,χ^(2)=2.305,P=0.316)。④盆腔转移和远处转移305例,放疗组(n=160)、单纯化疗组(n=125)和手术综合治疗组(n=20)的5年总生存期无差异。(38.10%vs 44.50%vs 36.10%,χ^(2)=0.785,P=0.675)。结论早期宫颈癌广泛性子宫切除术后单纯盆腔转移的患者,接受手术综合治疗及放疗的肿瘤结局均优于单纯化疗。远处转移病例或盆腔转移合并远处转移病例中,放疗组、单纯化疗组和手术综合治疗组患者的肿瘤学结局均无明显差异。Objective To compare the difference of oncological outcomes of different treatment methods for the recurrence of early cervical cancer after radical hysterectomy.Method Based on clinical diagnosis and treatment database for cervical cancer in China,patients with recurrence of early cervical cancer after radical hysterectomy were selected and divided into simple pelvic metastasis group,distant metastasis group and pelvic metastasis combined with distant metastasis group according tometastatic site,and then compared the oncology outcomes of different treatment methods,such as radiotherapy,chemotherapy alone or combined surgical treatment.Result Of the 63,926 cervical cancer cases,893 cases were finally included in the treatment after recurrence.Among them,①398 cases of simple pelvic recurrence,5-year overall survival(OS)in radiotherapy group(n=248)was higher than that in chemotherapy group(n=93)(61.90%vs 44.40%,χ^(2)=15.292,P<0.001),5-year OS in surgical comprehensive treatment group(n=57)was higher than that in chemotherapy group(68.50%vs 44.40%,χ^(2)=6.089,P=0.014),but no difference were found in the 5-year OS in radiotherapy group and surgical comprehensive treatment group(61.90%vs 68.50%,χ^(2)=0.244,P=0.621).②190 cases of distant metastasis,there was no difference in 5-year OS between radiotherapy group(n=67),chemotherapy group(n=92)and surgical comprehensive treatment group(n=31).(51.50%vs 59.20%vs 53.50%,χ^(2)=2.305,P=0.316).③305 cases of pelvic recurrence and distant metastasis,there was no difference in 5-year OS between radiotherapy group(n=160),chemotherapy group(n=125)and surgical comprehensive treatment group(n=20).(38.10%vs 44.50%vs 36.10%,χ^(2)=0.785,P=0.675).Conclusion Patients with simple pelvic recurrence after early cervical cancer after radical hysterectomy are recommended to take surgical comprehensive treatment or radiotherapy.However,in the cases of distant metastasis or pelvic recurrence combined with distant metastasis,there is no obvious difference in oncological outcomes of radi

关 键 词：宫颈肿瘤 广泛性子宫切除术 复发后再治疗 肿瘤学结果 

分 类 号：R737.37[医药卫生—肿瘤]