【摘要】 目的探讨2018年FIGO子宫颈癌新分期中ⅡA2期治疗策略。方法基于中国子宫颈癌临床诊疗项目大数据库,对47家医院于2004—2018年期间收治的1112例FIGO 2018ⅡA2期子宫颈癌病例,在真实世界研究条件下比较开腹广泛性子宫切除手术(ARH组)、新辅助化疗后行手术治疗(NACT组)、根治性放化疗(R-CT组)3种治疗方式的5年总体生存率(OS)及无瘤生存率(DFS)。结果 (1)从数据库中共筛选出ARH组471例,NACT组342例,R-CT组299例,中位随访时间45个月。(2)单因素分析结果,ARH组与NACT组5年OS和5年DFS差异无统计学意义(93.6%vs. 90.3%,P=0.068;90.0%vs. 84.5%,P=0.123);ARH组、NACT组肿瘤学结局均优于R-CT组(ARH vs. R-CT 5年OS:93.6%vs. 71.8%,P<0.001;5年DFS:90.0%vs. 69.4%,P<0.001;NACT vs. R-CT 5年OS:90.3%vs. 71.8%,P<0.001;5年DFS:84.5%vs. 69.4%,P<0.001)。(3)多因素分析结果,R-CT组是影响子宫颈癌患者死亡及复发/死亡的独立危险因素。结论对于FIGO 2018ⅡA2期子宫颈癌患者,直接开腹手术或新辅助化疗后手术可能是更好的选择。更多还原

【Abstract】 Objective To explore the treatment strategy for FTGO 2018 new stage Ⅱ A2 of cervical cancer.Methods Based on the big data databases of clinical diagnosis and treatment project for cervical cancer in China,1112 cases of FIGO 2018 Ⅱ A2 cervical cancer admitted to 47 hospitals from 2004 to 2018 were analyzed.The 5-year OS and 5-year DFS of the three treatment regimens-direct open extensive hysterectomy(ARH group),neoadjuvant chemotherapy(NACT group) and radical radiochemotherapy(R-CT group) were compared in real world conditions.Results(1) A total of 471 cases in the ARH group,342 cases in the NACT group and 299 cases in the R-CT group were selected from the 1538 project database,and the median follow-up was 45 months.(2)Univariate analysis showed that 5-year OS and 5-year DFS were not significantly different between the ARH group and the NACT group(93.6% vs.90.3%,P=0.068;90.0% vs.84.5%,P=0.123).The tumor outcomes in the ARH and NACT groups were better than those in the RCT group(for ARH vs.R-CT,5-year OS:93.6% vs.71.8%,P<0.001;5-year DFS:90.0% vs.69.4%,P<0.001),(for NACT vs.R-CT,5-year OS:90.3% vs.71.8%,P<0.001;5-year DFS:84.5% vs.69.4%,P<0.001).(3) Multivariate analysis showed that the R-CT group was an independent risk factor for death and recurrence/death of patients with cervical cancer.Conclusion For FIGO 2018 stage Ⅱ A2 cervical cancer,direct open surgery or surgery after neoadjuvant chemotherapy may be better options.更多还原