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目的:探讨手术综合治疗ⅡB期宫颈癌患者的临床疗效及预后影响因素。方法:选取2003-12-2005-12接受手术联合放疗和(或)化疗的ⅡB期原发宫颈癌患者75例,通过与同期住院的34例单纯放疗、54例同步放化疗患者进行生存率比较,评价手术综合治疗效果,并对可能的影响因素进行分析。结果:手术综合治疗组、单纯放疗组、同步放化疗组的1年生存率分别为96.00%、82.40%和92.60%,3年生存率分别为85.30%、67.60%和81.50%,5年生存率分别为75.50%、62.80%和79.60%。校正年龄因素后,手术综合治疗组的1年生存率高于单纯放疗组(χ2=5.975,P=0.015),与同步放化疗组相似;3、5年生存率差异无统计学意义。单因素分析结果提示,淋巴结转移、淋巴管癌栓、脉管癌栓及体质量指数与预后相关;多因素分析结果显示,淋巴结转移为其独立的危险因素,P=0.001,RR=5.936。结论:手术治疗ⅡB期宫颈癌患者是可以考虑的,淋巴结转移者预后差。
Objective: To investigate the clinical efficacy and prognostic factors of patients with stage ⅡB cervical cancer treated by surgery. Methods: Seventy-five patients with stage ⅡB primary cervical cancer undergoing surgery combined with radiotherapy and / or chemotherapy from December 2003 to December 2005 were enrolled in this study. The survival rates of 54 patients with concurrent radiotherapy and chemotherapy were compared with 34 radiotherapy alone , Evaluate the effect of comprehensive treatment of surgery, and analyze the possible influencing factors. Results: The 1-year survival rate was 96.00%, 82.40% and 92.60% respectively in the comprehensive surgery group, radiotherapy alone group and concurrent chemoradiotherapy group. The three-year survival rates were 85.30%, 67.60% and 81.50% respectively, and the 5-year survival rate Respectively 75.50%, 62.80% and 79.60%. After adjusting for age, the one-year survival rate of the comprehensive surgical treatment group was higher than that of the radiotherapy alone group (χ2 = 5.975, P = 0.015), which was similar to that of the concurrent chemoradiation group. There was no significant difference in the 3- and 5- year survival rates. The result of univariate analysis showed that lymph node metastasis, lymphatic embolism, vascular thrombosis and body mass index were correlated with prognosis. Multivariate analysis showed that lymph node metastasis was an independent risk factor, P = 0.001 and RR = 5.936. Conclusion: Surgical treatment of stage Ⅱ B cervical cancer patients can be considered, the prognosis of lymph node metastasis is poor.