Prognostic factors for relapse and pelvic lymph node metastases in early stage I adenocarcinoma of the cervix
Prognostic factors for relapse and pelvic lymph node metastases in early stage I adenocarcinoma of the cervix
复制标题
DOI：
10.1006/gyno.1999.5466
复制
发表时间：
1999-09-01
影响因子：
4.7
通讯作者：
Franseen, E
中科院分区：
文献类型：
--
作者：
Covens, A;Kirby, J;Franseen, E
目标。本研究的目的是评估局部肿瘤因素在预测早期宫颈腺癌淋巴结转移和/或复发中的预后意义。患者从妇科肿瘤科的前瞻性计算机宫颈癌数据库中选择。所有患者均行根治性手术和盆腔淋巴结清扫。研究人群包括肿瘤厚度< 10 mm的所有I期腺癌患者。重新检查病理以评估组织学亚型、深度、体积、分级和是否存在毛细血管淋巴间隙受累。研究组包括68例患者，平均年龄40岁。中位随访为40个月（8-102个月）。中位肿瘤深度和体积分别为2.8 mm（0.3-8.0 mm）和237 mm(3) （0.1-7996 mm）。22例患者肿瘤体积大于600mm(3)，其中5例（23%）患者盆腔淋巴结阳性(2)或复发(3)（无淋巴结阳性），中位时间为49个月。相比之下，46例（68%）患者肿瘤体积小于600 mm(3)，没有盆腔淋巴结阳性或复发（P < 0.005）。浸润深度为600 mm(3)的20例患者中仅有1例，而浸润深度为更深的48例患者中有21例（P < 0.002）。盆腔淋巴结阳性和/或复发的发生率在这个患者群体是非常低的。由于所有转移性疾病或复发患者的肿瘤体积均为600 mm(3)，因此疾病的体积而非浸润深度可能是上述事件最重要的预后因素。然而，要证实这一点，还需要对更多的患者进行研究。(C) 1999学术出版社。
Objectives. The aim of this study was to assess the prognostic significance of local tumor factors in predicting lymph node metastases and/or recurrence in early adenocarcinoma of the cervix.Methods. Patients were selected from the prospective computerized cervical cancer database of the division of gynecologic oncology. All patients had radical surgery and pelvic lymph node dissection. The study population consisted of all patients with stage I adenocarcinoma having tumor thickness < 10 mm. Pathology was re-reviewed to assess histological subtype, depth, volume, grade, and presence of capillary lymphatic space involvement.Results. The study group consisted of 68 patients, with a mean age of 40 years. The median follow-up was 40 months (range 8-102 months). The median tumor depth and volume were 2.8 mm (range 0.3-8.0 mm) and 237 mm(3) (range 0.1-7996 mms), respectively. Twenty-two patients had tumor volumes greater than 600 mm(3), and of these, 5 (23%) patients either had positive pelvic lymph nodes (2) or developed recurrent disease (3) (none node positive) at a median time of 49 months. In comparison, 46 patients (68%) had tumor volumes of less than 600 mm(3), none of whom had positive pelvic lymph nodes or developed recurrence (P < 0.005). Only 1 of 20 patients with a depth of invasion 600 mm(3) in comparison to 21 of 48 patients with deeper invasion (P < 0.002).Conclusion. The incidence of positive pelvic lymph nodes and/or recurrence in this patient population is very low. As all patients with metastatic disease or recurrence had tumor volumes >600 mm(3), volume of disease rather than depth of invasion may be the single most important prognostic factor for the above events. However, many more patients will have to be studied to confirm this. (C) 1999 Academic Press.