南颖 1王晓萌 2钟文芳 2宋玮琦 2黎志强 3任娇娇 2陈春林 3毛琛2
作者信息
- 1. 南方医科大学公共卫生学院,广东 广州 510515||南方医科大学护理学院,广东 广州 510515
- 2. 南方医科大学公共卫生学院,广东 广州 510515
- 3. 南方医科大学南方医院妇产科,广东 广州 510515
- 折叠
摘要
Abstract
Objective:To analyze the association between the number of lymph node metastases(LNM)on prognosis of patients with cervical cancer(CC),and to explore the rationality of integrating LNM numbers into In-ternational Federation of Gynecology and Obstetrics(FIGO)2018 staging system from an oncological outcome perspective.Methods:This retrospective analysis was conducted using data from 63926 patients treated in 47 medical institutions in mainland China between January 1,2004 and August 31,2018 within the Clinical Database of Cervical Cancer Treatment in China.After applying the inclusion and exclusion criteria,5462 patients were includ-ed in the study.Patients were divided into two groups based on the median number of LNM:the group with LNM<3(n=3417)and the group with LNM≥3(n=2045).Kaplan-Meier survival analysis and Log-rank test were used to compare 5-year overall survival(OS)and 5-year disease free survival(DFS)between the two groups.Meanwhile,Cox proportional risk regression model was used for multivariate analysis.In addition,according to LNM number and stage,and the FIGO 2018 ⅢC1 stage was reclassified into different subgroups:ⅢC1(FIGO 2018 ⅢC1+LNM<3),ⅢC2(FIGO 2018 ⅢC1+LNM≥3).The tumor outcomes of each subgroup were compared.Re-sults:①The 5-year OS of the LNM<3 group and LNM≥3 group were81.26%and68.57%,respectively,and the 5-year DFS were 72.48%and 56.66%,respectively(P<0.001).Multivariate analysis showed that after adjusting for age,histological type,tumor diameter,parametrial invasion,neural invasion,endocervical invasion,Iymphovas-cular space invasion,invasive carcinoma of the cervix,vaginal stump,preoperative adjuvant therapy,and postop-erative adjuvant therapy,the risk of death(HR 1.73,95%CI 1.51-1.98,P<0.001)and recurrence(HR 1.70,95%CI 1.53-1.90,P<0.001)in the LNM≥3 group was higher than that in the LNM<3 group.② In the new FIGO 2018 staging system redefined in this study,the 5-year OS of the ⅢC1 and ⅢC2 subgroups were 81.53%and 69.30%,respectively,and the 5-year DFS were 72.77%and 57.58%,respectively(P<0.001).Conclusions:The number of LNM could be a critical prognostic indicator for CC patients.Incorporating LNM count into the staging system may enhance prognostic accruracy.关键词
子宫颈癌/淋巴结转移数目/预后Key words
Cervical cancer/Nnumber of lymph nodes metastases/Prognosis分类
医药卫生
