宫颈癌根治术后阴道残端复发相关因素分析.docVIP

宫颈癌根治术后阴道残端复发相关因素分析 　　摘要：目的 探讨宫颈癌根治术后患者出现阴道残端复发的相关因素。方法 回顾分析173例宫颈癌根治术后患者的临床资料，包括临床分期、病理类型、阴道切缘情况、术后辅助放化疗及近距离放疗。结果 术后标本阴道切缘阴性组、阳性组的平均复发时间分别为（62.29±1.89）个月、（16.75±5.63）个月，两组比较有显著性差异（P0.01）；术后无治疗组、化疗组、放疗组、同步放化疗组的平均复发时间分别为（40.18±6.18）个月、（28.02±9.07）个月、（62.91±2.34）个月、（70.97±1.49）个月，同步放化疗组较其他三组的复发曲线比较均有显著性差异（P均0.05）；术后未行近距离放疗组、行近距离放疗组平均复发时间分别为（57.53±2.59）个月、（66.62±1.60）个月，两组比较有显著性差异（P0.05）。结论 宫颈癌根治术后阴道切缘阳性的患者，阴道残端复发的风险高。术后行同步放化疗可降低阴道残端复发的风险。近距离放疗能降低阴道残端复发的风险。 　　关键词：宫颈癌；阴道残端复发；同步放化疗；近距离放疗 　　Influential Factors for Recurrent Cervical Cancer of Vaginal Stump Following Radical Hysterectomy 　　LI Dan-qing1，QU Yi2，XU Xiao-ying2，LI Guo-quan2，ZOU Li-juan2 　　（1.Xingtai Peoples Hospital，Xingtai 054001，Hebei，China；2.The Second Hospital of Dalian Medical University，Dalian 116023，Liaoning，China） 　　Abstract：Objective To investigate the influential factors for recurrent cervical cancer at vaginal stump following radical hysterectomy.Methods This retrospective study was performed with data obtained from cases in Dalian Medical University.In total 173 cases who underwent surgical cervical cancer radical hysterectomy were studied.Results The mean time to relapse of negative and positive margin cases showed significant difference（62.29±1.89 months vs 16.75±5.63 months）.The chemoradiotherapy after surgery group predicted to have lower risk for recurrence than others（P0.05）.The mean time to relapse of with and without brachytherapy showed statistically significance（57.53±2.59 months vs 66.62±1.60 months）.Conclusion The patients whose vaginal cutting margin is positive have a higher recurrent risk to the negative patients.Chemoradiotherapy and rachytherapy could reduce the risk of recurrent cervical cancer of vaginal stump following radical hysterectomy. 　　Key words：Cervical cancer； Recurrence of vaginal stump； Concurrent radiotherapy and chemotherapy； Brachytherapy 　　宫颈癌是女性生殖系统最常见的恶性肿瘤之一，我国每年新发宫颈癌患者达13.15万[1]。早期宫颈癌5年的生存率可高达90%以上，但复发宫颈癌的5年生存率仅为3.2%[2-3]。Disaia等[4]的研究显示宫颈癌根治术后的复发，25%位于