Retrospective Research Of The470Cases Of Cervical Cancer

Objective: Cervical cancer is one of the most common gynecologicalmalignancies, whose incidence is the maxlmum of all the gynecologicalmalignancies in our state. Surgery assisted postoperative chemoradiation isone of the most important treatment to cervical cancer. But there are still somepatients have postoperative complications and death related with clinical stageand surgery manners. Therefore, we make a systematical retrospectiveresearch of470cases cervical cancer patients who were confirmed bypathology and addmited in the Fourth Hospital of Hebei Medical Universityfrom2008-8-1to2010-12-31and accepted operation. We principally analysisthe information about complications and mortality.Methods: We collected470cases cervical cancer patients who wereconfirmed by pathology, addmited in the Fourth Hospital of Hebei MedicalUniversity from2008-8-1to2010-12-31and accepted operation. Then werefered to their data and followed up closely. All the patients were followed upto2011-12-31. Then an Excel database is built with their clinical documents.There are417cases squamous cell carcinoma,26cases adenocarcinoma,18cases adenospine cell carcinoma and9cases rare pathology types includingclear cell carcinoma. They are divided into different stage under the cervicalcancer clinical stage guideline(FIGO,2009). There are49cases Ⅰa period,149cases Ⅰb1period,119cases Ⅰb2period,87cases Ⅱa1period,42casesⅡa1period and24cases Ⅱb period. The patients inⅠa, Ⅰb1and Ⅱa1period are divided into the early stage. The patients inⅠb2and Ⅱa2periodare divided into the locally advanced stage. The patients inⅡb period aredivided into the advanced stage. The key of the research is their circumstancesabout complications pathology risk factors and mortality on the base of theretrospective research. SPSS17.0software package was used. Univariateanalysis was assessed with chi square test. A statistically significant difference is indiciated by P<0.05.Result:1There are a total of67patients with postoperative complications in thisstudy. There are3cases of ureteral injury, including2cases of early stage and1case of locally advanced;2cases occurred in the type II hysterectomy and1case occurred in the type III hysterectomy. There are4cases of intestinalobstruction, including1case of early stage,2cases of locally advanced and1case of advanced;4cases all occurred in the type II hysterectomy. There are34cases of lymphocele, including18cases of early stage,13cases of locallyadvanced and3cases of advanced.24cases occurred in the type IIhysterectomy and9cases occurred in the type III hysterectomy,1caseoccurred after an additional pelvic lymph node resection. There are31cases ofbladder dysfunction, including18cases of early stage,12cases of locallyadvanced and1case of advanced.15cases occurred in the type IIhysterectomy and15cases occurred in the type III hysterectomy. There was agradually increasing trend in the complication rate of ureteral injury, intestinalobstruction, lymphocele and bladder dysfunction in the patients of early,locally advanced and advanced, but the difference was not statisticallysignificant (P>0.05). Compared with the type II hysterectomy, the type IIIhysterectomy has the higher incidence of bladder dysfunction, the differencewas statistically significant (P<0.05), but the difference in the incidence ofother complications such as ureteral injury, intestinal obstruction andlymphocele was not statistically significant (P>0.05).2The patients with pathological high-risk factors such as vaginalstump-posetive, lymph node metastasis and parametrial infiltration are a totalof115cases, including3cases of Ia stage,24cases of Ib1stage,34cases ofIb2stage,30cases of IIa1stage,13cases of IIa2stage,11cases of IIb stage.The locally advanced and advanced with high-risk factors are higher than theearly group, the difference is statistically significant (P<0.05) while thedifference between the locally advanced and advanced is not statisticallysignificant (P>0.05). 3There are16patients died during the follow-up period, including1caseof Ia period,3cases of Ib1period,3cases of Ib2period,4case of IIa1period,1case of IIa2period,4cases of IIb period.8cases of the death hadpathological high-risk factors,2cases of them accepted standardized treatmentand6case of them not.8cases of the death had no pathological high-riskfactors, including1case of Ia period,1cases of Ib1period,3cases of Ib2period,2case of IIa1period,1case of IIa2period. Compared with the earlyand locally advanced patients, the advavced patients have higher mortality, thedifference is statistically significant (P<0.05). the difference of mortalitybetween locally advanced and early is not statistically significant (P>0.05).patyological risk factors and postoperative standardized treatment arestatistically significant impact on postoperative mortality (P<0.05).Conclusion:1The incidence of postoperative complications tend to increase in theearly, locally advanced and advanced cervical cancer patients, but withoutstatistical significance. Surgery manners have a significant effect on theoccurrence of bladder dysfunction, but no significant effect on the occurrenceof ureteral injury, intestinal obstruction and lymphocele.2Compared with the early stage patients, the locally advanced andadvanced patients have more pathological risk factors. But there is nosignificant difference between the locally advanced and advanced patients onthe pathological risk factors.3The postoperative mortality in advanced patients is significantly higherthan the patients of early and locally advanced. And the same, the mortality ofpatients with risk factors is increased, and the standardized adjuvant therapy tothe patients with risk factors has a significant effect on the prognosis.