Clinical Analysis Of 246 Cases With Cervical Cancer

Objective: Cervical cancer is one of the most common gynecological malignancies. In recent years, the availability of measures have increased the rate of the early diagnosis and reduced the mortality of cervical cancer, such as cervical screening programs, the developing technique of early diagnose, the improving of the surgery and the rationalization of the treatment . However, there are still a lot of patients who have failed their treatments and had a poor outcomes, which remind us to concern the prognostic significance of cervical cancer, and then to establish the most reasonable treatment, strengthen of management and follow up. At present, investigators have evaluated multiple potential prognostic factors of cervical cancer. We would give a research of cervical cancer containing the clinical parameters (age, type of the tumor, stage, tumor size), pathological parameters (histology, grade, lymph node status, LVSI), adjuvant chemoradiotherapy, et al, and analysis the relative factors of pelvic lymph node metastasis in cervical cancer. To analyze retrospectively the clinical information of 246 patients withⅠb-Ⅱa cervical cancer during 5 years in the Fourth Hospital of Hebei Medical University. To evaluate the related risk factors affecting prognosis and the relationship between various clinicopathologic factors.Methods:The clinicopathologic factors and outcomes of 246 patients with cervical cancer underwent primary surgical treatment and confirmed by pathology from September 2000 to March 2005 in the Fourth Hospital of Hebei Medical University were reviewed and analyzed. An Excel database was built with clinical follow-up survey and analyze the prognostic factors of the cervical cancer.SPSS 13.0 software package was used. Multiple regression analysis were assessed by Logistic regression model. Univariate analysis were assessed withχ2 test. A statistically significant difference was indicated by P<0.05.Result:1 The average survival time of 246 cases with cervical cancer was 42 mo (2-133 mo), the median survival time 39 mo, and the 3-year, 5-year survival rate for all patients after surgery was 86.2% and 72.7%.2 The average age was 45 years old (27-77 years old). The median age was 47 years old. The peak focus on 40-44 and 50-54.3 Univariate analysis revealed that age, type of the tumor and stage had no association with survival rates (P>0.05); histology, grade , tumor size , LVSI, lymph node status and adjuvant chemoradiotherapy was associated with patients'prognosis (P<0.05).4 In multivariate analysis, age, histology, grade, LVSI, tumor size , lymph node status and adjuvant chemoradiotherapy was the independent prognostic factor for patients (P<0.05), while other factors were not.5 Comparison of various clinicopathologic factors related to lymph node metastasis, there were significant differences in tumor size, grade (P<0.05), except age, type of the tumor, stage and histology.6 Patients with cervical cancer underwent radical hysterectomy and simple or both salpingo-oophorectomy, radical hysterectomy, simple hysterictomy and salpingo-oophorectomy. Five-year survival rates were 79.0%, 74.6 %, 80.9%, 75.0%, respectively (P>0.05). The 5-year survival inpatients under-going lymphadenectomy was 79.8%, and it was 76.9% in patients without lym- phadenectomy, there was no difference statistically (P>0.05).Conclusion:1 Histology, grade, tumor size, LVSI, lymph node status and adjuvant chemoradiotherapy was the significant prognostic risk factor for patients.2 Age, histology, grade, LVSI, tumor size, lymph node status and adjuvant chemoradiotherapy was the independent predictor of outcome.3 Postoperative chemotherapy, postoperative radiotherapy and chemora diotherapy can raise patients'survival rate, the curative effect of the latter was better than the former.4 The patients with obturator, hypogastric, external iliac lymphatic meta- stasis had a poorer outcomes than patients with no lymphatic metastasis; patients with common iliac, inguinal lymph nodes metastasis had a high rate of relapse and mortality.5 The high risk factors for lymph node metastasis in cervical cancer include poorly differentiated and tumor size.6 The ovaries has not affected prognosis of cervical cancer. To underwent salpingooophorectomy does not increase the survival rate of cervical cancer pa -tients.7 The prognosis of cervical cancer is closely related to clinicpatho logical features. We should assess systematicly prognostic correlative factors of cerical cancer, work out a therapeutic schedule individually, to acquire well curative effect.