原发性外阴恶性肿瘤初始治疗后影响预后的相关因素分析  

Analysis of Related Factors Affecting Prognosis after Initial Treatment of Primary Vulvar Malignant Tumor

作　　者：郑乐[1] 贾海清 ZHENG Le;JIA Haiqing(Department of Gynecology,Cancer Hospital of Dalian University of Technology,Liaoning Cancer Hospital,Shenyang Liaoning 110042,China)

机构地区：[1]大连理工大学附属肿瘤医院、辽宁省肿瘤医院妇科,辽宁沈阳110042

出　　处：《实用妇产科杂志》2025年第2期158-163,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨原发性外阴恶性肿瘤初始治疗后影响预后的相关因素。方法:收集辽宁省肿瘤医院2005年1月1日至2018年9月30日收治的228例行初始治疗的原发性外阴恶性肿瘤患者的临床病例资料及随访资料,采用单因素及多因素Cox回归分析影响原发性外阴恶性肿瘤总体生存率(OS)的相关因素。结果:228例原发性外阴恶性肿瘤中位年龄为55岁(15~80岁),中位随访时间78个月。3年无进展生存率(PFS)为72.8%,3年OS为76.4%,5年OS为70.7%。单因素分析结果显示,年龄、肿瘤直径、淋巴结是否转移、临床分期、治疗方式均与5年OS有关(P<0.05)。多因素Cox分析结果显示,年龄>60岁(OR 3.96,95%CI 1.90~6.01)、肿瘤直径>4 cm(OR 3.58,95%CI 2.02~6.37)、淋巴结转移(OR 1.85,95%CI 1.28~3.00)是影响初始治疗后5年OS的独立危险因素(P<0.05)。结论:年龄、肿瘤直径和腹股沟淋巴结状态是原发性外阴恶性肿瘤初始治疗后影响预后的相关因素。若手术治疗后发现淋巴结转移或肿瘤直径较大等高危因素,建议术后补充放化疗,以改善生存预后。Objective:To explore the related factors affecting the prognosis of primary vulvar malignant tumors after initial treatment.Methods:The clinical and follow-up data of 228 patients with primary malignant tumor of the vulvar who received initial treatment at Liaoning Cancer Hospital from January 1,2005 to September 30,2018 were collected.Univariate and multivariate Cox regression analysis were used to identify factors affecting the overall survival rate(OS)of primary vulvar malignancies.Results:The median age of 228 patients of primary vulvar malignant tumors was 55(15-80),with a median follow-up time of 78 months.The 3-year progression free survival(PFS)rate was 72.8%,the 3-year OS rate was 76.4%,the 5-year OS was 70.7%.The results of univariate analysis showed that age,tumor diameter,lymph node metastasis,clinical stage and treatment method were all related to 5-year OS(P<0.05),Multivariate COX regression analysis showed that age>60 years(OR 3.96,95%CI 1.90-6.01),tumor diameter>4 cm(OR 3.58,95%CI 2.02-6.37),and lymph node metastasis(OR 1.85,95%CI 1.28-3.00)were independent risk factors affecting 5-year OS after initial treatment(P<0.05).Conclusions:Age,tumor diameter and inguinal lymph node status are related factors that affect the prognosis of primary vulvar malignant tumors after initial treatment.If high-risk factors exist,such as lymph node metastasis after operation or large tumor lesions,it is recommended to supplement radiotherapy and chemotherapy to improve survival prognosis.

关 键 词：原发性外阴恶性肿瘤 初始治疗 危险因素 生存预后 

分 类 号：R737.35[医药卫生—肿瘤]