妇科恶性肿瘤治疗后一年内未控与复发原因的研究——附全国61所医院1753例分析

PersistentandRecurrentGynecologicMalignantTumorTreatedwithinOneYear:Analysisof1753Casesfrom61HospitalsinChina

目的：分析妇科恶性肿瘤治疗后１年内未控与复发的原因。方法：对全国２４省、市的６１所医院１９８３～１９９３年收治的２０９７４例妇科恶性肿瘤病例中，治疗后１年内未控与复发的１７５３例进行回顾性分析。结果：卵巢恶性肿瘤和阴道癌的未控、复发率以及死亡率最高。１５８７例未控与复发病例中，５６．５２％在诊断时未行病理学分级检查。７６７例卵巢恶性肿瘤、１０３例宫颈癌及８９例子宫内膜癌的手术切除范围过小，分别为８１．６８％（７６７／９３９）、６４．３８％（１０３／１６０）及７０．０８％（８９／１２７）。５３２例卵巢癌、５９例绒癌及侵蚀性葡萄胎的化疗剂量偏小，分别为５５．４７％（５３２／９５９）及３８．３１％（５９／１５４）。２３５例宫颈癌的放疗剂量偏小，占５４．９０％（２３５／３９６）。结论：未行准确分期及治疗方法不规范是妇科恶性肿瘤患者治疗后１年内未控与复发的主要影响因素。

Objective:Toanalyzethecausesofpersistentandrecurrentgynecologicmalignanttu-morstreatedwithin1year.Methods:20974casesofgynecologicmalignanttumorsfrom61hospitalsin24provincesadmitedbetwen1983～1993werecolected.Outofthetotal,1753casestreatedwithin1yearwithtumorpersistence,recurenceordeathwereretrospectivelyanalysed.Results:Theovariancarcinomaandvaginalcancerhadthehighestratesoftumorpersistence,recurenceordeath.Amongthe1587casesoftumorpersistenceorrecurence,pathologicalgradingwerenotper-formedin56.52%ofthecases.Forsurgicaltreatment,inappropriateoperationweredonein81.68%(767/939)oftheovariancarcinoma,64.38%(103/160)ofthecervicalcarcinoma,and70.08%(89/127)oftheendometrialcancer.55.47%(532/959)ofovariancancerand38.31%(59/154)ofchoriocarcinomaandmalignantmolehadinsuficientchemotherapy.Forcervicalcancer,54.90%(235/396)ofthecasesdidnotreceiveenoughdosesofradiotherapy.Conclusion:Accuratestagingandstandardizedtherapyareimportantforimproving1yearsurvivalrateinmalignantgynecologictu-mors.