| Objective:To investigate the prognostic factors of cervical cancer. The safety and theeffectiveness of laparoscopic surgery for cervical cancer were evaluated.Methods:Cervical cancer patients which were treated with laparoscopic radicalhysterectomy and pelvic lymphadenectomy from January2005to December2009atour hospital were collocted and follow-uped.Postoperative survival time to startcounting from the day of operation，the deadline for August1,2013.Survived morethan5years is calculated according to5years, living at the end of follow-up wereregarded as censored data. The clinical data and follow-up results were analyzedretrospectively.Results:A total of267patients were identified. FIGO stage distribution described asfollows: stage Ⅰa:12cases, stage Ⅰb:98cases, stage Ⅱa:38cases, stage Ⅱb:119cases. The mean operative time was191.1min (65-370minutes).The averageintraoperative blood loss was274.6ml (60-160ml). The average stay after operationwas12.54days (5-47days). Squamous carcinoma was found in238cases,adenocarcinoma in21，adenosquamous in4,small cell neuroendocrine carcinoma in3,and Non-Hodgkin’s B-cell lymphoma in1(1.5%) patient.The presence of lymph nodemetastases occur in87patients,70patients had deep myometrial invasion,82cases inpatients with vascular invasion or lymphovascular space. A total of21cases ofperioperation complications occurred,6cases of vascular injury,1cases of rectalinjury,2cases of cystotomy, ureter injury in5cases, other operation injury in5cases,1cases of postoperative intestinal obstruction,1cases of deep vein thrombosis, thetotal complication rate peri operation period was7.87%. Postoperative complications include4cases of ureterovaginal fistula after operation,3cases of vesicovaginal fistula,1cases with ureteral stricture,40cases of bowel obstruction,35cases of dysuria. Atotal of186patients received radiotherapy and chemotherapy of different schemes.Survival time of patients who accepted radiotherapy or chemoradiotherapy was longerthan patients who received chemotherapy only (P=0.009). Survival rate of cervicalcancer after5year in stage Ⅰa for100%, Ib for87%, IIa stage70%, stage IIb68%,.5-year survival rates were varied on different stages (P=0.001), lymph node metastasis (P=0.00),deep muscle infiltration (P=0.003)and vascular invasion or lymphovascularspace (P=0.018). Different histopathological typing on postoperative survival timewas not significant difference(P=0.252).Conclusions:Our data demonstrate that laparoscopic surgery is a safe and effective option.The overall survival rate was varied according to the different stages of cervicalcancer and the presence of lymph node metastasis,deep muscle infiltration andvascular invasion or lymphovascular space. |
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