Clinical Analysis Of Two Treatments Performed For Occult Cervical Carcinoma

Background and ObjectiveCervical cancer is the most common malignancy in the world,which is ranked the fourth in morbidity and mortality.Most early cervical cancer patients underwent radical surgery,can have a high 5-year survival rate.However,sometimes benign lesions or cervical intraepithelial neoplasm which underwent total hysterectomy can find cervical cancer,which is occult cervical carcinoma.Occult cervical carcinoma is not common in clinical practice,mainly due to inadequate preoperative examination or can not be diagnosed in the intraoperative rapid frozen pathology.At present,simple hysterectomy is not enough for the occult cervical carcinoma,the recurrence rate of about 60%.According to the 2107 NCCN cervical cancer clinical practice guidelines,there are two treatments for patients with negative margins and poor imaging and no high-risk factors and intermediate-risk factors: radical parametrectomy and radiation therapy.However,there are few literatures on the best programs for treatment.After the treatment of these two programs,occult cervical carcinoma can achieve a high survival rate.The existence of complications can affect the quality of life of patients with varying degrees.With the improvement of modern living standards,people from the focus on survival,began to gradually shift to pay attention to the quality of life.Quality of life is a complex multidimensional structure that is usually evaluated using life therapy tools,which is the quality of life assessment table.In this study,the assessment of the quality of life of cervical cancer patients with FACT-Cx,by the general scale and cervical cancer specific scale.The study was to analysis the clinical effect of two treatments performed for occult cervical carcinoma and to assess the quality of life of the two treatment groups,total Laparoscopic radical parametrectomy and radiation therapy.MethodsThe clinical data of 32 cases with occult cervical cancers were analyzed retrospectivel from January 2011 to March 2015.17 cases that underwent radical parametrectomy and 15 cases underwent radiotherapy and chemotherapy.The operation time,intraoperative blood loss,intraoperative and postoperative complications of surgical group were recorded.The radiotherapy group was treated with early and late radiotherapy.The Age,BMI,pathological type,hospitalization expenses and hospital stay of the two groups were counted.At the end of the course of treatment,one year review was conducted to assess the quality of life of the patients using the questionnaire,and the qualities of life were assessed by cancer therapy scale systems of the FACT-general(FACT-G)and cervical cancer score(CCS).All the patients were followed up regularly until March 2017.SPSS 17.0 statistical software was used for statistical analysis.Quantitative variable was described as((x|-)± s).The difference between normal distribution of quantitative variable used independent-sample T text.and the two independent samples are used to compare the quantitative data.The Fisher exact test was used to text the qualitative variable.P <0.05 was considered statistically significant.All the patients were followed up regularly.Results1.During the follow-up period,there was 1 case recurrence in the surgical group and radiotiony group,respectively.The non-recurrence rate was 100% and 93.3%(P = 0.47),the difference was not statistically significant.No patients died during the follow-up period.2.The hospitalization expenses and hospital stays were statistically significant between the surgical and radiation group: The hospitalization expenses were 2392.4±4021.9 yuan and 46102.1±3495.1 yuan(P<0.05),and the hospitalization days were 14.3 ± 4.1 days and 32.6 ± 5.4 days(P <0.05),respectively.3.The scores of FACT-Cx(P=0.006),physical condition(P=0.02),and cervical cancer score(CCS)(P=0.001),were significantly higher in the operation group than those in the radiotherapy group.The difference was statistically significant.Social situation(P=0.31),emotional situation(P=0.218)and functional condition(P=0.077)differences were not statistically significant.4.There were 3 cases(17.6%)of the postoperative complications in the operation group,6 cases(40%)in the early radiotherapy group and 3 cases(20%)of the late complication.The difference of the complication rate between the two groups was statistically significant(P = 0.03)Conclusions1.Radical parametrectomy with pelvic lymphadenectomy and radiation therapy are effective treatments performed for occult cervical carcinoma.2.In our research center,radical parametrectomy has fewer complications,ease of postoperative recovery,etc.It can also reduce the economic burden and mental stress,increase patient compliance,and can retain young patients with ovarian function,Improve the quality of life,especially for young patients and patients worthy of clinical promotion.