Analysis of recurrence pattern and prognosis of patients with cervical envenoms and pelvic lymph node metastasis / 中华妇产科杂志

ABSTRACT

0bjective To investigate the pattern of disease relapse and prognostic risk factor of patients with cervical carcinoma and pelvic lymph node metastasis.Methotis A total of 124 cases of International Federation of Gynecology and Obstetricfi(FIG0)I bl-Ⅱ a cervical carcinoma with pelvic node metastasis who were treated at the Cancer Center of Sun Yat-sen University during January 1994 to December 2001 were selected for this study.Prognosis and recurrence were retrospectively analyzed using the clinico.pathological data.Results The overall 5 year flun,ival and 5 year disease-free survival were 63.3% and 61.4%.respectively.Overall recurrence rate was 39.5%(49/124),among which intra-pelvic relapse (61.0%,25/41)was significantly more common than extra-pelvic relapse(31.7%,13/41;P=0.008).Multivariate analysis identified involvement of common iliac node as an independent prognostic factor(P=O.035).According to this factor,node-positive patients could be divided into low risk group(without common iliac node involvement,104 cases)and hiSh risk group(with common iliac node involvement,20 cases).The 5 year disease-free survival were 69.4%and 24.5%respectively,with a significant difference(P=0.003).Intra.pelvic relapse was observed in 22.1%(23/104)of low risk and 25.0% (5/20)of high risk group respectively,with no significant difference(P>0.05).However extra-pelvicrelapse wag seen in 7.7%(8/104)of low risk and 40.0%(8/20)of hish risk group,with a significant difference(P<0.01).Conclusions Common iliac node involvement is a significant factor influencing the prognosis of patients with cervical carcinoma and pelvic lymph node metastasis.Patients with positive common iliae nodes have significantly decreased 5 year disease.free survival and hishcr extra-pelvic disease recurrence rates compared with those whose common iliac nodes are negative.These findings provide impo.rtant data for design of individualized treatment mode.