196例宫颈癌患者复发部位的预后意义

Prognostic Significance of Recurrent Sites in 196 Cases with Cervical Cancer

[目的]通过对不同复发部位宫颈癌患者的生存分析,探讨复发部位的临床预后意义。[方法]回顾性分析上海交通大学医学院附属第九人民医院2013年1月至2018年1月196例原发性宫颈癌接受初始放疗或术后放疗后复发的患者病例资料。部分患者接受积极挽救性治疗(aggressive salvage therapy,AST),通过单纯或联合应用外科手术切除、转移灶切除、同步放化疗等措施清除复发肿瘤。统计分析复发形式、AST率和生存结果。[结果]复发形式包括单纯远处复发(59.7%)、混合复发(22.4%)、中央型复发(10.2%)和盆腔复发(7.6%)。单纯远处淋巴结和肺实质转移患者预后良好,占复发患者的34.7%,单纯远处淋巴结和肺实质转移的患者中77.9%接受了AST治疗,且5年生存率最高(40.1%)。[结论]不同复发部位的宫颈癌患者预后不尽相同,其中单纯远端淋巴结和肺实质转移患者接受AST治疗后预后良好,但仍需要大规模前瞻性研究来进一步证实。

[Objective]To analyze the relationship between recurrence sites and clinical outcomes in cervical cancer patients.[Methods]The clinical data of 196 patients with primary cervical cancer who received initial or postoperative radiotherapy in the Ninth People’s Hospital Affiliated to Shanghai JiaoTong University Medical School from January 2013 to January 2018 were analyzed retrospectively.The relapsed patients were treated with aggressive salvage therapy(AST)to remove the recurrent tumors by surgical resection,metastasis resection,concurrent radiotherapy and chemotherapy.The recurrence pattern,AST rate,pattern and survival outcome were analyzed.[Results]The recurrence patterns included simple distant recurrence(59.7%),mixed recurrence(22.4%),central recurrence(10.2%)and pelvic recurrence(7.6%).Patients with simple distant lymph node and pulmonary metastases accounted for 34.7%of all relapsed patients,77.9%of whom received AST with the highest 5-year survival rate(40.1%).[Conclusion]The prognosis of cervical cancer patients with different recurrence sites is different.The prognosis of patients with simple distal lymph node and lung metastases is good after AST.Large scale prospective studies are still needed for further confirmation.