子宫颈癌开腹术后诊断为ⅢC1p期患者淋巴结转移与预后的关系

Relationship between lymph node metastases and the prognosis of uterine cervical cancer patients diagnosed at stageⅢC1p after abdominal surgery

目的探讨淋巴结转移与子宫颈癌开腹术后诊断为ⅢC1p期患者预后的相关性。方法回顾性分析2012年1月至2019年12月江苏省苏北人民医院收治的350例行子宫颈癌开腹根治性手术+术后同步放化疗患者的临床资料, 患者术前2018版国际妇产科联盟分期均为ⅠB~ⅡA期, 其中术后诊断为ⅢC1p期81例。采用Kaplan-Meier法分析不同因素分层患者生存情况, 采用多因素Cox比例风险模型分析患者预后影响因素。结果 81例子宫颈癌开腹术后诊断为ⅢC1p期患者中, 成功随访79例。Kaplan-Meier分析显示, 子宫旁浸润、淋巴结转移数>2个、淋巴结转移率>20%、髂总淋巴结转移患者无病生存(DFS)和总生存(OS)均较差(均P<0.05)。多因素Cox回归分析显示, 淋巴结转移数>2个(HR=5.38, 95%CI 1.30~22.20, P=0.020)是患者OS的独立危险因素, 淋巴结转移数>2个(HR=5.99, 95%CI 1.45~24.77, P=0.013)、髂总淋巴结转移(HR=4.91, 95%CI 1.17~20.55, P=0.029)是DFS的独立危险因素。结论淋巴结转移可能与子宫颈癌开腹术后诊断为ⅢC1p期患者预后相关, 淋巴结转移数>2个是患者OS和DFS的不良影响因素。

Objective To investigate the relationship between lymph node metastases and the prognosis of uterine cervical cancer patients diagnosed atⅢC1p after abdominal surgery.Methods The clinical data of 350 uterine cervical cancer patients preoperatively confirmed as 2018 International Federation of Gynecology and Obstetrics(FIGO)stageⅠB-ⅡA who underwent abdominal hysterectomy followed by postoperative concurrent chemoradiotherapy between January 2012 and December 2019 at Subei People's Hospital of Jiangsu Province were retrospectively analyzed,and there were 81 patients postoperatively diagnosed at stageⅢC1p.Kaplan-Meier method was used to analyze the survival of patients stratified by different factors,and multivariate Cox proportional risk model was used to analyze the factors affecting the prognosis of patients.Results Among 81 uterine cervical cancer patients diagnosed at stageⅢC1p after abdominal surgery,79 cases were successfully followed up.Kaplan-Meier analysis showed that patients with parametrial infiltration,the number of metastatic lymph nodes>2,metastatic lymph node rate>20 and common iliac lymph node metastasis had worse disease-free survival(DFS)and the overall survival(OS)(all P<0.05).Multivariate Cox proportional analysis showed that the number of metastatic lymph nodes>2(HR=5.38,95%CI 1.30-22.20,P=0.020)was an independent risk factor for OS;the number of metastatic lymph nodes>2(HR=5.99,95%CI 1.45-24.77,P=0.013),common iliac lymph node metastasis(HR=4.91,95%CI 1.17-20.55,P=0.029)were independent risk factors for DFS.Conclusion Lymph node metastasis may be associated with the prognosis of uterine cervical cancer patients diagnosed at stageⅢC1p after abdominal surgery.The number of metastatic lymph nodes>2 is a adverse influencing factor for OS and DFS.