现代妇产科进展2017，Vol.26Issue(12)：885-888,892,5.DOI:10.13283/j.cnki.xdfckjz.2017.12.034
286例Ⅰa1期年轻宫颈癌不同治疗方案对预后及生活质量的影响
The prognosis and quality of life following different surgical approach of 286 cases of cervical cancer stage Ia1 in young women.
摘要
Abstract
Objective:To analyze clinicopathologic features and outcomes of 286 women under 40 years old diagnosed with cervical cancer stage Ia1 following different surgical approaches,and the impact on the post-operative quality of life (QOL). Methods:A retrospec-tive cohort study over a 10-year period (2005 ~ 2014)was conducted,collecting clinicopatho-logic and follow-up data to compare the prognosisas well as QOL after different operational means. Results:The definite surgeries performed include 15(5. 2%)cases of conization or par-tial trachelectomy,189(66. 1%)cases of hysterectomy,82(26. 7%)cases of radical or modi-fied radical hysterectomy. After 3. 76±0. 44 years of follow-up,one case recurred with HSIL. There was no significant difference in recurrence rate and mortality among each operation group. Positive margin status and lymph vascular space invasion(LVSI),as well as pathologic subtype of cone margin were significantly associated with the residual disease. Of all the womenwho underwent secondary surgery for positive margin,6(3. 9%)had fertility-sparing surgery, 80(52. 6%)had simple hysterectomy and 66(43. 4%)had radical or modified radical hyster-ectomy. One patient of eight with LVSI had conizationas definitive surgical approach with no re-currence during 4 years of follow-up. Compared to simple hysterectomy,those who underwent radical surgery were influenced significantly by symptoms of lymphedema,skin numbness,sexu-al dysfunction as well as urination and defecation function disturbance. No difference of QOL was detected in hysterectomy group and fertility-sparing group. Conclusions:Even for patients without fertility-preservation desire,simple hysterectomy is an appropriate surgical option to maintain quality of life. When preservation of fertility is strongly requested,conization can be considered as the definite treatment. However,a close surveillance should be scheduled.关键词
宫颈癌Ⅰa1期/锥切切缘/淋巴脉管间隙浸润/保守手术/生活质量Key words
Cervical cancer stage Ia1/Cone margin/Lymph vascular space invasion (LVSI)/Conservative surgery/Quality of life分类
医药卫生引用本文复制引用
吴小肄,王维贵,郑颖馨,朱静..286例Ⅰa1期年轻宫颈癌不同治疗方案对预后及生活质量的影响[J].现代妇产科进展,2017,26(12):885-888,892,5.基金项目
上海市科研计划项目资助(No:15ZR1404800) （No:15ZR1404800）
