The Clinicopathologic Characters And Prognostics Analysis Of Cervical Carcinoma

[Objective]To study the associations between survival and clinicopathologic characters, as well as treatment protocols, of the patients with cervical cancer, ananlyze influencing factors on survival time of the patients, and provide important information for clinical doctors in diagnosing and treatments for cervical carcinoma.[Methods]The study sample was consisted of 1656 patients who were treated in Fujian Cancer Hospital from 2001 to 2007 through self-made questionnaire. At the first, the patients' information about disease condition and treatments was collected, and then their survival time was obtained by using follow-up method. To understand the patients'survival time with outpatient service, telephone, letters and visits and other methods, as to dead patients, to understand their time and cause of death. SPSS 15.0 and SAS8.2 for windows were used to analyze all of data.χ2 test and Fisher test were used to compare of the differences among pathological types. Kaplan-Meier method was used to calculate survival rates, and the differences of the survival rates among groups were analyze by Log-rank test. Unconditional Logistic regression, Cox proportional hazards model, and Weibull regression were used to analyze the influencing factors on survival time.[Results]1. The 3-year and 5-year survival rates of the 1656 cervical carcinoma patients were 86.27% and 82.82%. The 5-year survival rates of cervical carcinoma patients with simple surgery, radiotherapy alone and combined therapy were 95.10%,70.15% and 84.00%, respectively. The 5-year survival rates of which with preoperative adjuvant therapy, therapy after surgery, surgery plus radiotherapy and chemotherapy, and radiotherapy and chemotherapy were 93.23%,81.59%,83.70% and 76.53%, respectively. After adjusted by age, clinical stage, the difference of 3-year survival rates of the same clinical stage with different treatment methods was statistically significant, the differences of 5-year survival rates of the same clinical stage between simple surgery and radiotherapy alone, combined therapy were statistically significant, but the difference of 5-year survival rates of the same clinical stage between radiotherapy alone and combined therapy was not statistically significant.2. Univariate analysis showed that the patients, whose age≥60 years, clinical stageⅢ～Ⅳ, tumor size≥4cm, tumor type as the nodule cavity, body mass index<18.50kg/m2, years of diagnosis from 2001 to 2003, without surgical treatment, lymph node metastasis, lymphatic vessel invasion got poor prognosises, and the differences were statistically significant (P<0.05).3. Multivariate Logistic regression analysis showed that the factors affecting the 3-year survival time of the patients with cervical carcinoma:①surgical patients: clinical stage and lymph node metastasis;②all the patients:age, clinical stage, tumor type and whether surgery. The cliniciopathologic factors affecting the 5-year survival time:①surgical patients:clinical stage and lymph node metastasis;②all the patients: age, clinical stage and tumor type.4. Univariate analysis showed that the factors affecting lymph node metastasis of cervical carcinoma were tumor size and tumor type; multivariate Logistic regression analysis showed that tumor type, tumor size and age were into model. The prognosis of patients with lymph node metastasis by univariate analysis showed that clinical stage and histological type were statistically significant, multivariate analysis showed that clinical stage and histological type were into the model.5. The clinicicopathological prognostic factors of cervical carcinoma by Weibull regression analysis showed:①surgical patients:tumor type, lymph node metastasis and lymph vessel invasion, and the shape parameterγ=1.0780, it suggested that the death risk of surgical patients of cervical cancer increased with time, was an increased death model.②all the patients:age, whether surgery, tumor size, and the shape parameterγ=0.8534, it suggested that the death risk of the patients of cervical cancer decreased with time, was a decreased death model.[Conclusion]1. Clinical stage and lymph node metastasis were still the factors which affect the prognostic of cervical carcinoma.2. To measure the patient's condition, to use the appropriate treatment, to improve patients' survival and quality of life.3. To strengthen the work of primary prevention of cervical carcinoma, to research on effective methods screening cervical carcinoma from the high risk, early detection, early treatment, to improve the 5-year survival rate.