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
Objective： To study the influences of different time intervals between loop electrosurgical excision （LEEP） and abdominal hysterectomy or radical hysterectomy on postoperative complications. Methods： Sixty-eight p...Objective： To study the influences of different time intervals between loop electrosurgical excision （LEEP） and abdominal hysterectomy or radical hysterectomy on postoperative complications. Methods： Sixty-eight patients, who received subsequent abdominal hysterectomy or radical hysterectomy after LEEP due to C1N III and cervical cancer （IA1, IA2 and IB1）, were included in the present study. The hospital and clinic records of these patients were reviewed. The patients were divided into three groups according to the time intervals between LEEP and hysterectomy or radical hysterectomy： group l（within 48 h）, group 2 （between 48 h to 6 weeks）, and group 3（〉 6 weeks ）.Results： General characteristics of patients, including the mean age, delivery history, BMI, menopausal status, clinical stage and HPV infection, were comparable between patients of different groups. There were no significant differences in the mean transfusion amount, posthysterectomy hospital stay or operation time between different groups. The frequencies and spectrum of complications were not significantly affected by the time interval between LEEP and hysterectomy or radical hysterectomy. Conclusion： It is concluded that whenever the LEEP is done, the operation including hysterectomy or radical hysterectomy can be conducted at any time as it is necessary for the patients.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Objective： To study the influences of different time intervals between loop electrosurgical excision （LEEP） and abdominal hysterectomy or radical hysterectomy on postoperative complications. Methods： Sixty-eight patients, who received subsequent abdominal hysterectomy or radical hysterectomy after LEEP due to C1N III and cervical cancer （IA1, IA2 and IB1）, were included in the present study. The hospital and clinic records of these patients were reviewed. The patients were divided into three groups according to the time intervals between LEEP and hysterectomy or radical hysterectomy： group l（within 48 h）, group 2 （between 48 h to 6 weeks）, and group 3（〉 6 weeks ）.Results： General characteristics of patients, including the mean age, delivery history, BMI, menopausal status, clinical stage and HPV infection, were comparable between patients of different groups. There were no significant differences in the mean transfusion amount, posthysterectomy hospital stay or operation time between different groups. The frequencies and spectrum of complications were not significantly affected by the time interval between LEEP and hysterectomy or radical hysterectomy. Conclusion： It is concluded that whenever the LEEP is done, the operation including hysterectomy or radical hysterectomy can be conducted at any time as it is necessary for the patients.
