PROSPECTIVE SURGICAL PATHOLOGICAL-STUDY OF DISEASE-FREE INTERVAL IN PATIENTS WITH STAGE IB SQUAMOUS-CELL CARCINOMA OF THE CERVIX - A GYNECOLOGIC ONCOLOGY GROUP-STUDY
PROSPECTIVE SURGICAL PATHOLOGICAL-STUDY OF DISEASE-FREE INTERVAL IN PATIENTS WITH STAGE IB SQUAMOUS-CELL CARCINOMA OF THE CERVIX - A GYNECOLOGIC ONCOLOGY GROUP-STUDY
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DOI：
10.1016/0090-8258(90)90072-s
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发表时间：
1990-09-01
影响因子：
4.7
通讯作者：
MAJOR, F
中科院分区：
文献类型：
--
作者：
DELGADO, G;BUNDY, B;MAJOR, F
有 732 名可评估的患者患有原发性、先前未经治疗、经组织学证实的 I 期宫颈鳞状细胞癌，侵犯≥3 毫米。其中，645 例除子宫颈/子宫外没有肉眼可见的疾病，主动脉旁淋巴结阴性，并接受了根治性子宫切除术和盆腔淋巴结切除术。 545 例盆腔淋巴结阴性患者的 3 年无病间隔 (DFI) 为 85.6%，100 例盆腔淋巴结阳性患者的 3 年无病间隔 (DFI) 为 74.4%。大量盆腔淋巴结受肿瘤影响与较差的预后无关；对于 1 个、2 个、3 个或更多阳性盆腔淋巴结，DFI 分别为 72.1%、86.4% 和 64.6%。 DFI 与肿瘤浸润深度密切相关，无论是绝对值 (mm) 还是分数三分之一。 ⩽5 mm 的 DFI 为 94.6%，6–10 mm 的 DFI 为 86.0%，11–15 mm 的 DFI 为 75.2%，16–20 mm 的 DFI 为 71.5%，⩾21 mm 的 DFI 为 59.5%。按分数计算，浅三分之一的 DFI 为 94.1%，中三分之一的 DFI 为 84.5%，深三分之一的 DFI 为 73.6%。就临床肿瘤大小而言，隐匿性、≤3 cm 和 >3 cm 的 DFI 分别为 94.8%、88.1% 和 67.6%。毛细淋巴管间隙 (CLS) 阳性患者的 DFI 为 77.0%，CLS 阴性患者的 DFI 为 88.9%。肿瘤分级和宫旁状态与 DFI 相关。 DFI 在年龄、手术切缘疾病状态、肿瘤描述（例如外生性）、肿瘤涉及象限、子宫扩张和肿瘤细胞角化状态方面没有显着差异。临床肿瘤大小、CLS和肿瘤浸润深度是独立的预后因素。
There were 732 evaluable patients with primary, previously untreated, histologically confirmed stage I squamous carcinoma of the cervix with ⩾3-mm invasion. Of these, 645 had no gross disease beyond the cervix/uterus, had negative paraaortic lymph nodes, and had undergone a radical hysterectomy with pelvic lymphadenectomy. The 3-year disease-free interval (DFIs) for the 545 patients with negative pelvic nodes was 85.6%, and for the 100 with positive pelvic nodes, 74.4%. A large number of pelvic nodes involved with tumor was not correlated with a poorer prognosis; the DFIs were 72.1, 86.4, and 64.6% for one, two, and three or more positive pelvic nodes, respectively. DFI correlated strongly with depth of tumor invasion, both in absolute terms (mm) and infractional thirds. The DFI was 94.6% for ⩽5 mm, 86.0% for 6–10 mm, 75.2% for 11–15 mm, 71.5% for 16–20 mm, and 59.5% ⩾21 mm. In fractional terms, the DFI was 94.1% for superficial third, 84.5% for middle third, and 73.6% for deep third invasion. With respect to clinical tumor size, the DFIs were 94.8, 88.1, and 67.6% for occult, ⩽3 cm, and >3 cm, respectively. The DFI was 77.0% for those with positive capillarylymphatic spaces (CLS) and 88.9% for those with negative CLS. Tumor grade and parametrial status correlated with DFI. DFI was not significantly different for age, disease status of the surgical margins, tumor description (e.g., exophytic), quadrant involved with tumor, uterine extension, and keratinizing status of tumor cells. Clinical tumor size, CLS, and depth of tumor invasion were independent prognostic factors.