Objective To compare survival outcomes between primary radical surgery and primary radiation in early cervical cancer.Methods Patient information was extracted from the Surveillance,Epidemiology,and Results database.P...Objective To compare survival outcomes between primary radical surgery and primary radiation in early cervical cancer.Methods Patient information was extracted from the Surveillance,Epidemiology,and Results database.Patients diagnosed with early cervical cancer of stage T1a,T1b,and T2a(American Joint Committee on Cancer,7th edition)from 1998 to 2015 were included in this study after propensity score matching.Overall survival(OS)was analyzed using the Kaplan-Meier method.Results Among the 4964 patients included in the study,1080 patients were identified as having positive lymph nodes(N1),and 3884 patients were identified as having negative lymph nodes(N0).Patients with primary surgery had significantly longer 5-year OS than those with primary radiotherapy in both the N1 group(P<0.001)and N0 group(P<0.001).In the subgroup analysis,similar results were found in patients with positive lymph nodes of stage T1a(100.0%vs.61.1%),T1b(84.1%vs.64.3%),and T2a(74.4%vs.63.8%).In patients with T1b1 and T2a1,primary surgery resulted in longer OS than primary radiation,but not in patients with T1b2 and T2a2.In multivariate analysis,the primary treatment was identified as an independent prognostic factor in both N1 and N0 patients(HR_(N1)=2.522,95%CI=1.919–3.054,PN1<0.001;HR_(N0)=1.895,95%CI=1.689–2.126,PN0<0.001).Conclusion In early cervical cancer stage T1a,T1b1,and T2a1,primary surgery may result in longer OS than primary radiation for patients with and without lymph node metastasis.展开更多
The management of cervical lymph node metastases of squamous cell carcinoma from an unknown primary site is still a therapeutic challenge.We report here our experience in treating these patients with chemoradiotherapy...The management of cervical lymph node metastases of squamous cell carcinoma from an unknown primary site is still a therapeutic challenge.We report here our experience in treating these patients with chemoradiotherapy as a curative approach.Data from 40 patients were reviewed.In total,20(50%) patients underwent excisional biopsy.All patients underwent radiotherapy,which was delivered to both sides of the neck and pharyngeal mucosa(extensive field),and concurrent chemotherapy consisting of weekly cisplatin at a dose of 40 mg/m2.The clinical stage of the cervical nodes at presentation was N1 in 25%,N2 in 60%,and N3 in 15%.Most patients(75%) developed at least grade 3 mucositis.Eight patients(20%) had grade 3 xerostomia and 18 patients(45%) required esophageal dilation for stricture.The 5-year overall survival(OS) rate of all patients was 67.5%.The 5-year OS rates of patients with N1,N2,and N3 lesions were 100%,67%,and 41%,respectively(P = 0.046).The 5-year progression-free survival rate was 62.5%.In multivariate analysis,only N stage significantly affected OS(P = 0.022).Emergence of the occult primary was very limited(1 patient only).Our results suggest that extensive irradiation of both sides of the neck and pharyngeal mucosa with concurrent chemotherapy results in a lower emergence of primary tumor.Because the survival of patients with unknown primary is comparable to that of patients with known primary,an attempt at cure should always be made.展开更多
目的:分析瑞芬太尼复合丙泊酚麻醉在颈淋巴结结核手术中的应用效果。方法:选择2021年11月—2022年11月于南京市中西医结合医院接受手术治疗的颈淋巴结结核患者94例为研究对象,采用随机数字表法将其分为对照组与研究组,各47例。对照组接...目的:分析瑞芬太尼复合丙泊酚麻醉在颈淋巴结结核手术中的应用效果。方法:选择2021年11月—2022年11月于南京市中西医结合医院接受手术治疗的颈淋巴结结核患者94例为研究对象,采用随机数字表法将其分为对照组与研究组,各47例。对照组接受氯胺酮复合丙泊酚麻醉,研究组接受瑞芬太尼复合丙泊酚麻醉。比较两组进入手术室时(T1)、诱导后(T2)、切皮时(T3)、清理病灶(T4)、术毕(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)及脉搏血氧饱和度(SpO2)、苏醒时间、术后15 min Aldrete评分、麻醉相关不良反应。结果:T_(1)~T_(5),研究组各项生命体征比较,差异无统计学意义(P>0.05);T_(1)~T_(5),对照组SpO2水平比较,差异无统计学意义(P>0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于T1,差异有统计学意义(P<0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于研究组,差异有统计学意义(P<0.05);研究组苏醒时间短于对照组,术后15 min的Aldrete评分高于对照组,差异有统计学意义(P<0.001);研究组麻醉相关不良反应发生率低于对照组,差异有统计学意义(P=0.037)。结论:在颈淋巴结结核手术中,采用瑞芬太尼复合丙泊酚麻醉效果较好,患者的血流动力学更为平稳,且术后苏醒较快,安全性较好。展开更多
基金This study was supported by a grant from the National Natural Science Foundation of China(No.81602629).
文摘Objective To compare survival outcomes between primary radical surgery and primary radiation in early cervical cancer.Methods Patient information was extracted from the Surveillance,Epidemiology,and Results database.Patients diagnosed with early cervical cancer of stage T1a,T1b,and T2a(American Joint Committee on Cancer,7th edition)from 1998 to 2015 were included in this study after propensity score matching.Overall survival(OS)was analyzed using the Kaplan-Meier method.Results Among the 4964 patients included in the study,1080 patients were identified as having positive lymph nodes(N1),and 3884 patients were identified as having negative lymph nodes(N0).Patients with primary surgery had significantly longer 5-year OS than those with primary radiotherapy in both the N1 group(P<0.001)and N0 group(P<0.001).In the subgroup analysis,similar results were found in patients with positive lymph nodes of stage T1a(100.0%vs.61.1%),T1b(84.1%vs.64.3%),and T2a(74.4%vs.63.8%).In patients with T1b1 and T2a1,primary surgery resulted in longer OS than primary radiation,but not in patients with T1b2 and T2a2.In multivariate analysis,the primary treatment was identified as an independent prognostic factor in both N1 and N0 patients(HR_(N1)=2.522,95%CI=1.919–3.054,PN1<0.001;HR_(N0)=1.895,95%CI=1.689–2.126,PN0<0.001).Conclusion In early cervical cancer stage T1a,T1b1,and T2a1,primary surgery may result in longer OS than primary radiation for patients with and without lymph node metastasis.
文摘The management of cervical lymph node metastases of squamous cell carcinoma from an unknown primary site is still a therapeutic challenge.We report here our experience in treating these patients with chemoradiotherapy as a curative approach.Data from 40 patients were reviewed.In total,20(50%) patients underwent excisional biopsy.All patients underwent radiotherapy,which was delivered to both sides of the neck and pharyngeal mucosa(extensive field),and concurrent chemotherapy consisting of weekly cisplatin at a dose of 40 mg/m2.The clinical stage of the cervical nodes at presentation was N1 in 25%,N2 in 60%,and N3 in 15%.Most patients(75%) developed at least grade 3 mucositis.Eight patients(20%) had grade 3 xerostomia and 18 patients(45%) required esophageal dilation for stricture.The 5-year overall survival(OS) rate of all patients was 67.5%.The 5-year OS rates of patients with N1,N2,and N3 lesions were 100%,67%,and 41%,respectively(P = 0.046).The 5-year progression-free survival rate was 62.5%.In multivariate analysis,only N stage significantly affected OS(P = 0.022).Emergence of the occult primary was very limited(1 patient only).Our results suggest that extensive irradiation of both sides of the neck and pharyngeal mucosa with concurrent chemotherapy results in a lower emergence of primary tumor.Because the survival of patients with unknown primary is comparable to that of patients with known primary,an attempt at cure should always be made.
文摘目的:分析瑞芬太尼复合丙泊酚麻醉在颈淋巴结结核手术中的应用效果。方法:选择2021年11月—2022年11月于南京市中西医结合医院接受手术治疗的颈淋巴结结核患者94例为研究对象,采用随机数字表法将其分为对照组与研究组,各47例。对照组接受氯胺酮复合丙泊酚麻醉,研究组接受瑞芬太尼复合丙泊酚麻醉。比较两组进入手术室时(T1)、诱导后(T2)、切皮时(T3)、清理病灶(T4)、术毕(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)及脉搏血氧饱和度(SpO2)、苏醒时间、术后15 min Aldrete评分、麻醉相关不良反应。结果:T_(1)~T_(5),研究组各项生命体征比较,差异无统计学意义(P>0.05);T_(1)~T_(5),对照组SpO2水平比较,差异无统计学意义(P>0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于T1,差异有统计学意义(P<0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于研究组,差异有统计学意义(P<0.05);研究组苏醒时间短于对照组,术后15 min的Aldrete评分高于对照组,差异有统计学意义(P<0.001);研究组麻醉相关不良反应发生率低于对照组,差异有统计学意义(P=0.037)。结论:在颈淋巴结结核手术中,采用瑞芬太尼复合丙泊酚麻醉效果较好,患者的血流动力学更为平稳,且术后苏醒较快,安全性较好。
