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首页> 外文期刊>International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics >The potential for less radical Surgery in women with stage IA2-IB1 cervical cancer
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The potential for less radical Surgery in women with stage IA2-IB1 cervical cancer

机译：IA2-IB1期宫颈癌女性少做根治性手术的潜力

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Objective: To identify a subset of patients with stage IA2-IB1 cervical cancer and small tumors (<= 2 cm) who could be suitable for less radical surgery. Methods: In a retrospective study, the medical records of women treated at nine hospitals in China were reviewed. Included women had undergone radical hysterectomy and pelvic lymph node dissection. The clinicopathologic factors associated with uterine isthmus invasion (UII), vaginal invasion (VI), parametrial invasion (PI), lymph node metastasis (LNM), and prognosis were analyzed. Results: Overall, 1632 women were included. Tumor size greater than 2 cm (measured postoperatively) was an independent predictor of VI (P = 0.002), PI (P = 0.001), and UII (P = 0.021). Squamous cell carcinoma and superficial stromal invasion were associated with a low frequency of Ull (P < 0.001 for both). Among patients with adenocarcinoma, deep stromal invasion and lymphovascular space involvement (LVSI) were independently associated with UII (P = 0.006 and P = 0.004, respectively). Grade 2/3 disease (P = 0.009), deep stromal invasion (P = 0.015), and LVSI (P < 0.001) were independently associated with LNM. LNM was the only independent adverse factor for survival (P < 0.001). Conclusion: Women with stage IA2-IB1 cervical cancer with low-risk factors could be candidates for large-scale prospective clinical trials of less radical surgery and lymphadenectomy omission. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
机译：目的：确定亚IA2-IB1期宫颈癌和小肿瘤（<= 2 cm）的患者亚组，这些患者可能适合于根治性较低的手术。方法：通过回顾性研究，回顾了在中国9家医院接受治疗的妇女的病历。纳入的妇女接受了根治性子宫切除术和盆腔淋巴结清扫术。分析与子宫峡部浸润（UII），阴道浸润（VI），子宫旁浸润（PI），淋巴结转移（LNM）和预后相关的临床病理因素。结果：总共包括1632名女性。大于2 cm的肿瘤大小（术后测量）是VI（P = 0.002），PI（P = 0.001）和UII（P = 0.021）的独立预测因子。鳞状细胞癌和浅表基质浸润与低频率的Ull有关（两者均P <0.001）。在患有腺癌的患者中，深层基质浸润和淋巴管间隙受累（LVSI）与UII独立相关（分别为P = 0.006和P = 0.004）。 2/3级疾病（P = 0.009），深层基质浸润（P = 0.015）和LVSI（P <0.001）与LNM独立相关。 LNM是生存的唯一独立不利因素（P <0.001）。结论：患有低风险因素的IA2-IB1期宫颈癌女性可以作为大规模的前瞻性临床试验的候选人，这些临床试验应包括较少根治性手术和省略淋巴结清扫术的患者。 （C）2015年国际妇产科联合会。由Elsevier Ireland Ltd.发布。保留所有权利。

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