| Objective:This study observed the short-term prognosis of patients who suffered from cervical squamous cell carcinoma with the stage Ⅱ a2, analyzed the features and efficacy of various treatments and analyzed the prognostic factors that may impact the patients’short-term prognosis. The aim of this study is to provide reference and basis for the clinical development of individualized treatment plan.Methods:Selected clinical, pathologic, and follow-up data of patients admitted to gynecology in the Fourth Affiliated Hospital of Hebei Medical University between July25,2008and December31,2010.They all suffered from cervical squamous cell carcinoma with the stage Ⅱ a2(according to the2009staging of FIGO). They all in accordance with the following three criteria:First,all the patients were examined by two or more gynecologists,who had the professional title of Deputy Chief Physician.They were all confirmed to be patients with cervical squamous cell carcinoma of the stage Ⅱ a2by pathology after surgery; Second, they all have complete medical records and pathological data; Third, they have a relatively complete follow-up data. We followed up regularly when all the treatment was completed. We chose telephone as the follow-up method. We specify December31,2012as the follow-up deadline, the last follow-up covered all studies. The survival time of patients means the period from surgical procedure day to last follow-up time or the death of the research object. We analyzed the clinical data of each patient such as age, number of childbirth, tumor morphology, differentiation degree, depth of muscular invasion, within or without vascular invasion, pelvic lymph node metastasis, whether the ovaries were removed, treatment modality and evaluated survival influencing factors. We used SPSS13.0for statistical analysis, Kaplan-Meier to calculate the survival rate, and made use of Log-rank non-parametric test for survival rate comparison. By the use of COX proportional hazards regression model for multivariate analysis of the factors that P values less than0.05.P<0.05represents statistical significance. The survival cases at the final follow-up time, the missing and the non-cancer deaths were processed as censored data in statistical analysis.Results:There were4patients died in the whole group. The2-year overall survival rate was90.91%(40/44). The2-year survival rate of those treated by surgery first was91.89%(34/37),while the other group who accepted neoadjuvant chemotherapy before surgery was85.71%(6/7), the difference had no statistical significance(χ2=0.237,P=0.626). Univariate analysis showed that the2-year survival rate of the younger group(≤40) was lower than the older group(>40),the difference had statistical significance (χ2=7.843,P=0.005); the2-year survival rate of the group with positive pelvic lymph nodes was lower than the other group, the difference had statistically significance (χ2=6.038,P=0.014).The patients within vascular invasion had lower2-year survival rate compared with those without vascular invasion, the difference had statistical significance (χ2=6.026,P=0.014).That means the age, vascular invasion, pelvic lymph node metastasis all influent the short-term prognosis of cervical squamous cell carcinoma(P<0.05). But the number of childbirth, tumor morphology,differentiation degree,depth of muscular invasion, whether the ovaries were removed had no influence on the short-term prognosis of cervical squamous cell carcinoma(P<0.05). Multifactor analysis showed that age, pelvic lymph node metastasis and vascular invasion were not independent influences to the short-term prognosis of cervical squamous cell carcinoma (P=0.053,0.086,0.669).Conclusion:Compared with the group whose members were treated by surgery first,the group that accepted neoadjuvant chemotherapy before surgery had no higher2-year survival rate,that means neoadjuvant chemotherapy before surgery could not improve the short-term prognosis or the2-year survival rate of the patients. The factors such as age, pelvic lymph node metastasis and vascular invasion had significant impact on the patient’s short-term prognosis. But these three factors were not the independent influences to the short-term prognosis of cervical squamous cell carcinoma. |
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