Objective:This study investigated the prognostic significance of age at diagnosis, stage, tumor subtype, pelvic lymph node metastasis (PLNM), lymph-vascular space involvement (LVSI), presence or absence of deep cervic...Objective:This study investigated the prognostic significance of age at diagnosis, stage, tumor subtype, pelvic lymph node metastasis (PLNM), lymph-vascular space involvement (LVSI), presence or absence of deep cervical stromal invasion (DCSI) in stage ⅠB-ⅡA cervical cancer patients. It also investigated the inter-relationship among these factors. Methods: 152 patients treated with radical hysterectomy plus pelvic lymphadenectomy were followed up for a median of 49 months and were evaluated retrospectively. Results: The 5-year overall survival rate was 84.8%. The distribution of age at diagnosis is of bimodal shape, peaking at 42 and 68 years, respectively. Tumor subtype, PLNM, DCSI, and LVSI were found to be significant prognostic factors individually. After multivariate analysis, only tumor subtype and PLNM were found to be independent, significant prognostic factors for survival. The prognostic importance of LVSI appeared to be eclipsed by the presence of PLNM. DCSI was statistically related with FIGO stage, LVSI and PLNM. Conclusion: Tumor subtype and PLNM are the two most important independent prognostic factors for stages ⅠB-ⅡA cervical cancer. Some prognostic factors are inter-related and may reflect different facets of tumor progression.展开更多
目的：探讨保守性手术以及手术联合药物治疗不同类型子宫内膜异位症合并不孕患者的疗效。方法：回顾性分析因子宫内膜异位症合并不孕而接受保守性手术治疗的患者共235例，随访12-36月（平均19．19±6．70月）。结果：198例完成随访...目的：探讨保守性手术以及手术联合药物治疗不同类型子宫内膜异位症合并不孕患者的疗效。方法：回顾性分析因子宫内膜异位症合并不孕而接受保守性手术治疗的患者共235例，随访12-36月（平均19．19±6．70月）。结果：198例完成随访，随访率84．26％（198／235）。术后妊娠率为35．86％（71／198），继发不孕者术后妊娠率明显高于原发不孕（54．55％ VS 26．52％，P〈0．001）。单纯腹膜型子宫内膜异位症、腹膜型联合卵巢内膜样囊肿合并不孕患者术后妊娠率明显高于腹膜型联合子宫腺肌病合并不孕患者（39．71％、37．96％ VS 13．64％，P〈0．05）。原发不孕和单纯腹膜型子宫内膜异位症合并不孕术后加用GnRH-a治疗组术后妊娠率高于未用药组（34．67％ VS 17．39％，58．62％ VS 25．71％，P〈0．05）。结论：①保守性手术可提高术后妊娠率，尤其对继发不孕；②手术对于单纯腹膜型子宫内膜异位症以及腹膜型联合卵巢内膜样囊肿合并不孕患者有明显的疗效；③原发不孕以及单纯腹膜型子宫内膜异位症患者术后加用GnRH-a治疗可以增加术后妊娠率。展开更多
文摘Objective:This study investigated the prognostic significance of age at diagnosis, stage, tumor subtype, pelvic lymph node metastasis (PLNM), lymph-vascular space involvement (LVSI), presence or absence of deep cervical stromal invasion (DCSI) in stage ⅠB-ⅡA cervical cancer patients. It also investigated the inter-relationship among these factors. Methods: 152 patients treated with radical hysterectomy plus pelvic lymphadenectomy were followed up for a median of 49 months and were evaluated retrospectively. Results: The 5-year overall survival rate was 84.8%. The distribution of age at diagnosis is of bimodal shape, peaking at 42 and 68 years, respectively. Tumor subtype, PLNM, DCSI, and LVSI were found to be significant prognostic factors individually. After multivariate analysis, only tumor subtype and PLNM were found to be independent, significant prognostic factors for survival. The prognostic importance of LVSI appeared to be eclipsed by the presence of PLNM. DCSI was statistically related with FIGO stage, LVSI and PLNM. Conclusion: Tumor subtype and PLNM are the two most important independent prognostic factors for stages ⅠB-ⅡA cervical cancer. Some prognostic factors are inter-related and may reflect different facets of tumor progression.
文摘目的：探讨保守性手术以及手术联合药物治疗不同类型子宫内膜异位症合并不孕患者的疗效。方法：回顾性分析因子宫内膜异位症合并不孕而接受保守性手术治疗的患者共235例，随访12-36月（平均19．19±6．70月）。结果：198例完成随访，随访率84．26％（198／235）。术后妊娠率为35．86％（71／198），继发不孕者术后妊娠率明显高于原发不孕（54．55％ VS 26．52％，P〈0．001）。单纯腹膜型子宫内膜异位症、腹膜型联合卵巢内膜样囊肿合并不孕患者术后妊娠率明显高于腹膜型联合子宫腺肌病合并不孕患者（39．71％、37．96％ VS 13．64％，P〈0．05）。原发不孕和单纯腹膜型子宫内膜异位症合并不孕术后加用GnRH-a治疗组术后妊娠率高于未用药组（34．67％ VS 17．39％，58．62％ VS 25．71％，P〈0．05）。结论：①保守性手术可提高术后妊娠率，尤其对继发不孕；②手术对于单纯腹膜型子宫内膜异位症以及腹膜型联合卵巢内膜样囊肿合并不孕患者有明显的疗效；③原发不孕以及单纯腹膜型子宫内膜异位症患者术后加用GnRH-a治疗可以增加术后妊娠率。
