| Objective:To explore the related factors affecting the poor prognosis of cervical stump squamous cell carcinoma and adenocarcinoma,and provide some reference for its clinical diagnosis and treatment.Methods: The clinical data of patients with 45 cases of cervical stump squamous cell carcinoma and adenocarcinoma,who were admitted to the Cancer Hospital of Xinjiang Medical University from January 1,2005 to December 1,2016 were retrospectively analyzed.Results:The median age of diagnosis was 51 years old.The mainly cause of subtotal hysterectomy was uterine fibroids.The average time from subtotal hysterectomy to definite diagnosis was 10.76 years.The clinical manifestations are mostly irregular vaginal bleeding.In the IA-IIA stage,19 patients(39.6%)were treated with surgery+adjuvant therapy;and in IIB-IV stage,29 patients(60.4%)were treated with radiotherapy combined with chemotherapy.The follow-up time of these cervical stump carcinoma was 5 years after tumor diagnosis,the 1?3?5-year survival rate was 97.67%?83.46%?73.94%.Univariate analysis: the time from subtotal hysterectomy(P<0.001),tumor diameter(P=0.022?P=0.008),clinical stage(P=0.011),histological grade(P=0.009 ? P<0.001),parametrial invasion(P=0.004 ? P=0.001),and radical surgery(P=0.021)had an effect on the poor prognostic of the disease.Cox regression multivariate analysis showed parametrial invasion and histological grade was an independent risk factor for recurrence and metastasis,it was also a protective factor for recurrence and metastasis.Conclusions:Factors such as tumor diameter,clinical stage,histological grade,lymph node metastasis,parametrial invasion and myelosuppression affect the poor prognosis of the cervical stump squamous cell carcinoma and adenocarcinoma.And histological grade is an independent risk factor.Therefor,the patients with risk factors should be actively treated and closely followed up to find the recurrence and metastasis in time,so as to improve the survival rate of patients. |
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