Clinical Significance Of Early Cervical Cancer Radical Surgery Combined With Abdominal Aortic Lymph Nodedissection

Objective: To study the clinical significance of cervical cancer radical resection and para-aortic lymph node dissection in patients with early cervical cancer and to analyze the general situation and related clinical and pathological factors of pelvic lymph node metastasis and para-aortic lymph node metastasis in patients with early stage cervical cancer To discuss the predictive value of SCC-Ag level before treatment in pelvic lymph node metastasis and para-aortic lymph node metastasis.Methods: From March 2013 to April 2017,IA2 to IIA1 cervix patients undergoing surgical treatment at the First Affiliated Hospital of Bengbu Medical College were selected and 200 patients were included.The patients were divided into a treatment group and a control group according to different surgical methods;Cervical cancer radical resection(wide uterine double annexectomy + pelvic lymph node dissection)+ abdominal aortic lymph node dissection was performed in 60 patients in the treatment group.140 patients undergoing radical cervical cancer radical resection were the control group.Followed by NCCN guideline,adjuvant therapy was given after surgery.The amount of intraoperative blood loss,operation time,incidence of surgical complications,postoperative tumor recurrence rate and survival rate were observed and compared;and the age,clinical stage,histological classification,and pathological differentiation were observed.The tumor diameter,pre-treatment blood SCC,cervical myometrial infiltration depth,vascular invasion,and parametrial infiltration were used to explore the effect on lymph node metastasis.Results : The 200 patients with IA2 to IIA1 cervical cancer undergoing surgical treatment at the First Affiliated Hospital of Bengbu Medical College were selected between the ages of 27 to 69 years,the average age of 49 years,and the median age of 48 years.The treatment time and duration of treatment The hemorrhage volume was(176.85±19.86)min and(246.79±27.83)mL respectively,and the control group was(168.58±17.55)min and(215.95±16.24)mL respectively.There was no significant difference between the two groups(all P> 0.05).The incidence of complications was 18.3% in the treatment group and 17.1% in the control group.The difference was not statistically significant(P>0.05).The recurrence rate was 16.7% in the treatment group and 33.5% in the control group.The difference was significant(P<0.05).The 4-year survival rate was 91.7% in the treatment group and 77.9% in the control group,with a statistically significant difference(P<0.01).Of the 200 patients,44 patients had pelvic lymph node metastasis,and the pelvic lymph node metastasis rate was 22.0%.The rate of pelvic lymph node metastasis in IA,IB stage and IIA stage was 12.5%,19.8%,and 29.7%,respectively.From the clinicopathological of age,clinical stage,histological classification,pathological differentiation,pre-treatment blood SCC,tumor diameter,depth of cervical myometrial infiltration,vascular invasion,and parametrial infiltration,the pelvic lymphatic rate was only Before treatment,blood SCC,clinical stage,tumor diameter,and myometrial infiltration depth of the cervix were statistically significant(all P<0.05).In the treatment group,there were 10 patients with paraaortic lymph node metastases and the abdominal aorta was adjacent to them.The lymph node metastasis rate was 16.7%.The rates of paraaortic lymph node metastasis in the IA,IB,and IIA stages were 0,15.2%,and 25.0%,respectively.The positive rate of para-aortic lymph nodes was higher in lymph node metastasis ? 2 pieces,tumor diameter ? 4cm,clinical stage is later,and pre-treatment blood SCC> 1.96 ng/mL(all P<0.05).Conclusion :The rate of paraaortic lymph node metastasis in early cervical cancer was related to the level of blood SCC before treatment,the number of pelvic lymph node metastasis,tumor diameter,clinical stage;Patients with relatively late stage,abnormally elevated SCC,and large tumor diameter are advised to perform abdominal aortic lymph node dissection;Early abdominal cervical aortic lymph node dissection can guide postoperative treatment and improve prognosis.