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目的:探讨Ⅱb期宫颈癌术前化疗联合手术治疗疗效。方法:回顾性分析2003年5月-2005年5月我院手术治疗的53例Ⅱb期宫颈癌患者的病例资料,根据术前是否行化疗,分为术前化疗组和直接手术组,比较 2组的近期疗效、手术时间、术中出血量、术后留置尿管时间、术中及术后并发症、盆腔淋巴结转移率等。结果:53 例术后病理阴道断端均无癌转移。术前化疗组淋巴结阳性7例,占术前化疗人数的17．9％;直接手术组淋巴结阳性6例,占直接手术人数的42．9％,术前化疗组与直接手术组比较,盆腔淋巴结转移显著减少(P<0．01),2组手术时间、术中出血量、术后留置尿管时间、术后并发症等的差异无统计学意义。结论:Ⅱb期宫颈癌术前新辅助化疗是有效的治疗方法,能提高手术的切除率,从而使宫颈癌手术治疗适应证可以扩大到Ⅱb期,不增加手术时间、术中出血量及术后并发症。
Objective: To investigate the efficacy of preoperative chemotherapy combined with surgical treatment of stage IIb cervical cancer. Methods: We retrospectively analyzed the data of 53 patients with stage IIb cervical cancer surgically treated in our hospital between May 2003 and May 2005. According to whether or not chemotherapy was performed before surgery, the patients were divided into preoperative chemotherapy group and direct surgery group. The group’s short-term efficacy, operative time, intraoperative blood loss, postoperative catheter length, intraoperative and postoperative complications, and pelvic lymph node metastases. RESULTS: None of the 53 cases had pathological vaginal stump metastasis. Preoperative chemotherapy group lymph node positive in 7 cases, accounting for 17.9% of the number of preoperative chemotherapy; direct surgery group lymph node positive in 6 cases, accounting for 42.9% of the number of direct surgery, preoperative chemotherapy group compared with direct surgery group, pelvic lymph nodes The metastasis was significantly reduced (P<0.01). There was no significant difference in the operative time, intraoperative blood loss, postoperative indwelling catheter time, and postoperative complications between the 2 groups. Conclusions: Preoperative neoadjuvant chemotherapy for stage IIb cervical cancer is an effective treatment, which can increase the resection rate of the operation, so that the indication for surgical treatment of cervical cancer can be expanded to stage IIb without increasing the operation time, intraoperative blood loss, and postoperative complication.