FIGO 2018ⅢC1p期宫颈癌患者的预后分析

An analysis of prognostic factors for patients with FIGO 2018 stageⅢC1p cervical cancer

目的:探讨FIGO 2018ⅢC1p期宫颈癌患者的预后危险因素。方法:收集2015年1月至2018年6月在蚌埠医学院第一附属医院接受手术治疗并经病理确诊具有淋巴结转移的宫颈癌患者139例,所有患者均行广泛性全子宫切除加盆腔淋巴结±腹主动脉旁淋巴结清扫术。结果:139例患者3年无病生存期(disease-free survival,DFS)为71.4%。多因素分析显示,淋巴结转移数目≥3个和术前中性粒细胞和淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)≥2.16是影响ⅢC1p期宫颈癌患者预后的独立危险因素(P<0.05)。根据危险因素将所有患者分为三组,进一步分析显示,低风险组(无危险因素)、中风险组(1个危险因素)、高风险组(2个危险因素)的3年DFS分别为90.4%、54.3%、30.3%(P<0.05)。结论:FIGO 2018ⅢC1p期宫颈癌的患者是不同质的,淋巴结转移数目和术前NLR是3年DFS的独立预后因素,宫颈癌分期可考虑将此因素纳入分期范围,并对于ⅢC1p期的患者制定更加个体化的治疗方案。

Objective:To evaluate the prognostic factors for patients with FIGO 2018 stageⅢC1p cervical cancer.Methods:139 patients with lymph node metastasis confirmed by pathology after surgery at the First Affiliated Hospital of Bengbu Medical University,between January 2015 and June 2018 were collected.All patients underwent radical hysterectomy and systematic bilateral pelvic lymphadenectomy and/or para-aortic lymphadenectomy.Results:3-yeardisease-free survival(DFS)of patients was 71.4%.Multivariate analysis showed that number of metastatic lymph nodes≥3 and preoperative neutrophil-lymphocyte ratio(NLR)≥2.16 were independent risk factors affecting the prognosis of stageⅢC1p cervical cancer patients(P<0.05).The patients was classified into three groups based on the number of identified prognostic factors.We further analyzed that the 3-year DFS of patients in low risk group(without prognostic factor),intermediate risk group(with one prognostic factor),high risk group(with two prognostic factors)was 90.4%,54.3%and 30.3%,respectively(P<0.05).Conclusion:StageⅢC1p patients were heterogeneous.The number of metastatic lymph nodes and preoperative NLR were independent prognostic factors for 3-year DFS in patients.The next revision of FIGO staging system should take these factors into account.Individualized treatment strategies should be formulated for patients with stageⅢC1p.