Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer.
Predictors for pathological parametrial invasion in clinical stage IIB cervical cancer.
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DOI：
10.1016/j.ejso.2019.02.019
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发表时间：
2019-08
期刊：
影响因子：
--
通讯作者：
Sugiyama T
中科院分区：
文献类型：
--
作者：
Matsuo K;Shimada M;Nakamura K;Takei Y;Ushijima K;Sumi T;Ohara T;Yahata H;Mikami M;Sugiyama T
研究临床IIB期宫颈癌病理性宫旁浸润的预测因素，并研究病理性IIB期疾病的预后因素。这项研究是对全国范围内6,003例临床IB-IIB期宫颈癌回顾性队列的辅助分析。对接受原发性广泛子宫切除术和淋巴结切除术的临床IIB期疾病妇女进行了检查（n = 714）。进行多变量分析，以确定独立的临床病理因素的病理宫旁浸润，并确定独立的预后因素的病理IIB期疾病。在400例手术标本上发现宫旁侵犯（56.0%，95%置信区间52.4-59.7）。多变量分析显示，深部间质浸润（DSI，调整OR 3.922）、盆腔淋巴结多发转移（调整OR 3.266）、淋巴血管间隙浸润（调整OR 2.333）和子宫体浸润（调整OR 1.656）仍然是病理性宫旁浸润的独立肿瘤因素。在分类树模型中，有DSI和盆腔多个淋巴结转移的肿瘤的病理性宫旁浸润的发生率最高（75.0-87.7%），相反，没有DSI的肿瘤的发生率最低（21.9%）。在病理学IIB期疾病患者中，5年无病生存率的绝对差异为57.2%，范围为无/单盆腔淋巴结转移的鳞状组织学患者的80.9%和多盆腔淋巴结转移的非鳞状组织学患者的23.7%。在临床IIB期宫颈癌中，病理性宫旁浸润的准确性低至中等。在没有DSI的情况下，只有五分之一的临床IIB期疾病具有病理学IIB期疾病。病理IIB期的存活率变化很大，并且在很大程度上取决于淋巴结因素。
To examine predictors of pathological parametrial invasion in clinical stage IIB cervical cancer, and to examine prognostic factors in pathological stage IIB disease. This study is an ancillary analysis of a nation-wide retrospective cohort examining 6,003 clinical stage IB-IIB cervical cancers. Women with clinical stage IIB disease who underwent primary radical hysterectomy with lymphadenectomy were examined (n = 714). Multivariate analysis was performed to identify independent clinico-pathological factors for pathological parametrial invasion and to identify independent prognostic factors in pathological stage IIB disease. Parametrial invasion was identified on the surgical specimen in 400 cases (56.0%, 95% confidence interval 52.4–59.7). On multivariate analysis, deep stromal invasion (DSI, adjusted-OR 3.922), multiple pelvic nodal metastases (adjusted-OR 3.266), lympho-vascular space invasion (adjusted-OR 2.333), and uterine corpus invasion (adjusted-OR 1.656) remained independent tumor factors for pathological parametrial invasion. In classification-tree models, tumors with DSI and multiple pelvic nodal metastases had the highest incidence of pathological parametrial invasion (75.0–87.7%); contrary, tumors without DSI had the lowest incidence (21.9%). Among patients with pathological stage IIB disease, the absolute difference in 5-year disease-free survival rates was 57.2%, ranging between 80.9% in those with squamous histology with none/single pelvic nodal metastasis and 23.7% in those with non-squamous histology with multiple pelvic nodal metastases. In clinical stage IIB cervical cancer, accuracy for pathological parametrial invasion is low-modest. With absence of DSI, only one in five clinical stage IIB diseases has pathological stage IIB disease. Survival of pathological stage IIB varies widely and is largely dependent on nodal factors.
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影响因子：
3.9
作者：
Matsuo K;Shimada M;Saito T;Takehara K;Tokunaga H;Watanabe Y;Todo Y;Morishige KI;Mikami M;Sugiyama T
通讯作者：
Sugiyama T
影响因子：
5.9
作者：
Thomeer, Maarten G.;Gerestein, Cees;Hunink, Myriam G.
通讯作者：
Hunink, Myriam G.
DOI：
10.1016/s0360-3016(96)00619-0
发表时间：
1997-03-01
影响因子：
7
作者：
Gaspar, L;Scott, C;Byhardt, R
通讯作者：
Byhardt, R
影响因子：
8.8
作者：
Matsuo, K.;Mabuchi, S.;Okazawa, M.;Matsumoto, Y.;Tsutsui, T.;Fujita, M.;Kamiura, S.;Ogawa, K.;Morrow, C. P.;Kimura, T.
通讯作者：
Kimura, T.
影响因子：
3.3
作者：
Ebina, Yasuhiko;Yaegashi, Nobuo;Yoshikawa, Hiroyuki
通讯作者：
Yoshikawa, Hiroyuki