Characteristics and outcomes of reproductive-aged women with early-stage cervical cancer: trachelectomy vs hysterectomy.
Characteristics and outcomes of reproductive-aged women with early-stage cervical cancer: trachelectomy vs hysterectomy.
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DOI：
10.1016/j.ajog.2018.08.020
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发表时间：
2018-11
影响因子：
9.8
通讯作者：
Matsuo K
中科院分区：
文献类型：
--
作者：
Machida H;Mandelbaum RS;Mikami M;Enomoto T;Sonoda Y;Grubbs BH;Paulson RJ;Roman LD;Wright JD;Matsuo K
对于希望未来生育的患有早期宫颈癌的育龄女性，宫颈切除术是首选治疗方法。到目前为止，一直缺乏全面的基于人群的统计数据。
比较因早期宫颈癌接受宫颈切除术的育龄女性与接受子宫切除术的女性的特征和生存率。
这是一项回顾性观察研究，对1998年至2014年的监测、流行病学和最终结果计划进行了研究。将年龄小于45岁、患有IA期和IB1期（肿瘤大小≤2厘米）宫颈癌且接受宫颈切除术的女性与接受子宫切除术的女性进行比较。使用多变量模型来确定与宫颈切除术相关的临床病理因素。在倾向评分匹配后比较两组之间的生存率。
在6359名女性中，190人（3.0%，95%置信区间[CI]为2.6 - 3.4）接受了宫颈切除术。宫颈切除术组的中位年龄为31岁（四分位间距为28 - 34岁）。在研究期间，接受宫颈切除术的女性比例显著增加（1998 - 2002年为1.2%，2003 - 2008年为3.0%，2009 - 2014年为4.5%，P<0.001）。年龄较小、非黑人种族、单身婚姻状况、东部登记地区、近期疾病诊断、非鳞状组织学类型以及较高分期是与使用宫颈切除术相关的独立因素（所有因素，校正后P<0.05）。在倾向评分匹配后，宫颈切除术组和子宫切除术组的5年病因特异性生存率（96.9%对96.6%，风险比0.73，95%CI为0.23 - 2.30，P = 0.59）和总生存率（96.1%对96.6%，风险比0.76，95%CI为0.26 - 2.20，P = 0.61）相似。
我们的研究发现，近年来患有IA期或IB1期（≤2厘米）宫颈癌的育龄女性接受宫颈切除术的比例显著增加。在这一人群中，宫颈切除术的生存率与接受子宫切除术的生存率相似。
Trachelectomy is the treatment of choice for reproductive-aged women with early-stage cervical cancer who desire future fertility. Comprehensive population-based statistics have been missing to date. To compare characteristics and survival of reproductive-aged women who underwent trachelectomy for early-stage cervical cancer to those who had hysterectomy. This is a retrospective observational study examining the Surveillance, Epidemiology, and End Results Program between 1998 and 2014. Women less than 45 years of age with stage IA and IB1 (tumor size ≤2 cm) cervical cancer who underwent trachelectomy were compared to those who underwent hysterectomy. Multivariable models were used to identify clinico-pathological factors associated with trachelectomy. Survival was compared between the two groups after propensity score matching. Among 6,359 women, 190 (3.0%, 95% confidence interval [CI] 2.6–3.4) underwent trachelectomy. The median age of the trachelectomy group was 31 years (inter-quartile range, 28–34). The proportion of women who underwent trachelectomy significantly increased during the study period (1.2% in 1998–2002, 3.0% in 2003–2008, and 4.5% in 2009–2014, P<0.001). Younger age, non-black race, single marital status, Eastern registry area, recent disease diagnosis, non-squamous histology, and higher stage were independent factors associated with trachelectomy use (all, adjusted-P<0.05). After propensity score matching, 5-year cause-specific survival (96.9% versus 96.6%, hazard ratio 0.73, 95%CI 0.23–2.30, P=0.59) and overall survival (96.1% versus 96.6%, hazard ratio 0.76, 95%CI 0.26–2.20, P=0.61) were similar between the trachelectomy group and the hysterectomy group. Our study found that there was a significant increase in the proportion of reproductive-aged women with stage IA or IB1 (≤2cm) cervical cancer who underwent trachelectomy in recent years. Survival with trachelectomy was similar to those who had hysterectomy in this population.
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DOI：
10.6004/jnccn.2010.0107
发表时间：
2010-12-01
影响因子：
13.4
作者：
Abu-Rustum, Nadeem R.;Sonoda, Yukio
通讯作者：
Sonoda, Yukio
DOI：
10.7326/0003-4819-127-8_part_2-199710151-00064
发表时间：
1997-10-15
影响因子：
39.2
作者：
Rubin, DB
通讯作者：
Rubin, DB
DOI：
10.1097/igc.0b013e318295fb41
发表时间：
2013-07-01
影响因子：
4.8
作者：
Lintner, Balazs;Saso, Srdjan;Ungar, Laszlo
通讯作者：
Ungar, Laszlo
影响因子：
4.7
作者：
Kato, Tomoyasu;Takashima, Atsuo;Kamura, Toshiharu
通讯作者：
Kamura, Toshiharu
影响因子：
4.7
作者：
Ramirez, Pedro T.;Schmeler, Kathleen M.;Frumovitz, Michael
通讯作者：
Frumovitz, Michael