Utility of risk-weighted surgical-pathological factors in early-stage cervical cancer.
Utility of risk-weighted surgical-pathological factors in early-stage cervical cancer.
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DOI：
10.1038/bjc.2013.78
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发表时间：
2013-04-02
影响因子：
8.8
通讯作者：
Kimura, T.
中科院分区：
文献类型：
--
作者：
Matsuo, K.;Mabuchi, S.;Okazawa, M.;Matsumoto, Y.;Tsutsui, T.;Fujita, M.;Kamiura, S.;Ogawa, K.;Morrow, C. P.;Kimura, T.
关键词：
通过加权与宫颈癌生存率和治疗反应相关的多个危险因素的显著性程度来评估手术病理学危险因素。从540例IA 2-IIB期宫颈癌根治性子宫切除标本中获得7个病理因素，对生存结局进行多因素分析。确定每个风险因素的风险比（HR），并确定每个病例相应风险因素的HR评分总和。根据HR加权评分的程度评价生存曲线和术后治疗反应（同步放化疗（CCRT）vs单纯放疗）。与无病生存率（DFS）相关的危险因素的风险比为：淋巴血管间隙浸润3.95，淋巴结转移3.88，腺癌3.40，大肿瘤2.36，阳性边缘1.99，深部间质浸润1.29，宫旁浸润1.21。HR加权评分法对复发有较高的预测价值（曲线下面积0.836，P<0.001）。危险比加权评分与无病生存率呈负相关，评分≥ 12.5的病例5年无病生存率为23.8%。评分较大的肿瘤抵消了CCRT术后辅助治疗优于单纯放疗的优势（P<0.001）。手术病理风险因素为早期宫颈癌的生存和管理提供了有价值的信息，当风险的数量和意义进行加权。
Surgical–pathological risk factors were evaluated by weighting the magnitude of significance of multiple risk factors correlating to survival and treatment response in cervical cancer. Multivariate analysis was performed for survival outcomes entering seven pathological factors obtained from 540 radical hysterectomy specimens in stage IA2-IIB cervical cancer cases. Hazard ratio (HR) in each risk factor was determined, and the sum of HR scores for the corresponding risk factors was determined per case. Survival curves and postoperative treatment response (concurrent chemoradiotherapy (CCRT) vs radiotherapy alone) were evaluated based on the extent of HR-weighted scores. Hazard ratios for risk factors relating to disease-free survival (DFS) was: lympho-vascular space invasion 3.95, nodal metastasis 3.88, adenocarcinoma 3.40, large tumour 2.36, positive margin 1.99, deep stromal invasion 1.29, and parametria invasion 1.21. The HR-weighted scoring method showed a high predictive value for recurrence (area-under-curve 0.836, P<0.001). Hazard ratio-weighted scores were negatively correlated to DFS, and the cases with score ⩾12.5 showed 5-year DFS rate of 23.8%. Tumours with larger score offset the benefits of CCRT over radiotherapy alone for postoperative adjuvant treatment (P<0.001). Surgical–pathological risk factors provide valuable information for survival and management of early-stage cervical cancer when number and significance of risks are weighted.
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影响因子：
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作者：
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通讯作者：
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