根治性子宫切除术联合术前同步放化疗治疗局部晚期宫颈癌的临床疗效及预后多因素分析

摘要

Objective To explore the clinical efficacy of radical hysterectomy and preoperative concurrent chemoradio -therapy for locally advanced cervical carcinoma and multiple factors analysis of prognosis .Methods The data of 160 cases of lo-cally advanced cervical carcinoma were retrospectively analyzed .All the subjects underwent radical hysterectomy .78 cases in group A were given preoperative radiotherapy and 82 cases of group B received concurrent chemoradiotherapy .5-year survival rates and 5-year disease free survival rates were compared between the 2 groups,and the prognosis was analyzed by multivariate cox analysis.Results 5-year survival rates and 5-year disease free survival in group B were superior to group A (P<0.05);Un-ivariate analysis results showed that tumor diameter , age, lymphatic metastasis and preoperative concurrent chemoradiotherapy were related with survival rate .Multivariate cox analysis results showed that tumor diameter ,lymphatic metastasis and preoperative concurrent chemoradiotherapy were the independence factors for prognosis .Conclusion Radical hysterectomy and preoperative concurrent chemoradiotherapy for locally advanced cervical carcinoma greatly prolong the survival period .Tumor diameter ,lym-phatic metastasis and preoperative concurrent chemoradiotherapy are the independent factors for prognosis .%目的：探讨根治性子宫切除术联合术前同步放化疗治疗局部晚期宫颈癌的临床疗效及预后多因素分析。方法选择四川大学华西第二医院诊治的160例局部晚期宫颈癌患者临床资料进行回顾性分析。所有患者均行根治性子宫切除术，其中78例患者（ A组）术前行放疗治疗，82例患者（ B组）行术前同步放化疗。比较2组患者5年生存率、5年无瘤生存率的差别，并对患者预后进行Cox多因素分析。结果 B组5年生存率与5年无瘤生存率显著优于A组（ P＜0．05）。单因素分析结果显示：肿瘤直径、年龄、淋巴结转移、同步放化疗与患者生存率相关；多因素分析结果显示：肿瘤直径、淋巴结转移及同步放化疗是影响患者预后的独立因素。结论根治性子宫切除术联合术前同步放化疗可显著延长局部晚期宫颈癌生存期，肿瘤直径、淋巴结转移及同步放化疗是影响患者预后的独立因素。