[Analysis of the security, pregnancy outcomes, and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy].

OBJECTIVE: To explore the security, pregnancy outcomes, and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy (RT). METHODS: Thirty-two young patients < 40 years of age with early cervical cancer from May 2004 to July 2012 admitted in Tumor Hospital Xiangya School of Medicine of Central South University were divided into two groups based on different operation methods: vaginal radical trachelectomy (RVT) group and abdominal radical trachelectomy (RAT) group.The clinical data were analyzed by One-way Anova and multivariate Cox stepwise regression analysis. RESULTS: The operation duration, number of lymph node dissection, the height of the cervical resection, postoperative hospitalization time, incidence of vascular injury and incidence of postoperative lymphocele were respectively (250 ± 82) min, 15 ± 6, (2.31 ± 0.21) cm, (9.2 ± 2.9) d, 1/18 and 1/18 in RVT group, while (263 ± 60) min,16 ± 8, (2.32 ± 0.26) cm, (10.3 ± 3.5) d,0 and 1/14 in RAT group. There was no statistically significant difference between the two groups (all P > 0.05). The blood loss (281 ± 201) ml in RVT group was significantly lower than that in the RAT group (492 ± 320) ml (P < 0.05). The length of Vaginal hysterectomy [(2.61 ± 0.50) cm] and the width of parametrial resection [ (2.38 ± 0.36) cm] in RVT group were significantly less than those [(2.95 ± 0.10), (2.81 ± 0.22) cm] in the RAT group (all P < 0.05).The pregnancy rate between RVT group (3/18) and RAT group (2/14) were no significant difference (P > 0.05).One-way Anova analysis showed that the recurrence of early cervical cancer was related to tumor size in diameter (F = 4.911, P = 0.047), while there were no correlation with age, clinical stage, histological type and surgical approach (all P > 0.05).Multivariate analysis showed that tumor diameter size was an independent risk factor for tumor recurrence (ß = 0.259, P = 0.031). CONCLUSIONS: RT for young patients with early cervical cancer is feasible.Pregnancy outcomes after RT need to be study in the future. Tumor size in diameter is the major risk factor for tumor recurrence.

[Comparative study of different chemotherapy approaches for advanced epithelial ovarian cancer].

OBJECTIVE: To probe into the advantages and disadvantages of intravenous chemotherapy and intraperitoneal chemotherapy for advanced epithelial ovarian cancer. METHODS: All of the 226 patients with advanced epithelial ovarian cancer were treated by maximum cytoreductive surgery or non-effective cytoreductive surgery and received 6 - 8 courses of postoperative regular chemotherapy (chemotherapy regimens, TP: taxol and cis-platinum or carboplatinum; PC: cis-platinum and cyclophosphamide; PAC: cis-platinum and adriamycin and cyclophosphamide) during Jan 1998 - Jan 2006. We systematically compared the characteristics of patients in intraperitoneal chemotherapy (IPC) group and intravenous chemotherapy (IVC) group. We measured the incidence rate of the response, side-effects, the recurrence time of intraperitoneal tumor and survival time of the two groups respectively. RESULTS: For the first phase after operation (three courses of treatment), the response rate of two groups were 75.8% and 52.8% respectively. For the response rate of IPC was higher than that of IVC (P < 0.01). The second phase after operation (all courses finished), the response rate of two groups were 93.9% and 87.7%, respectively (P > 0.05). After maximum cytoreductive surgery, the recurrence rate of IPC and IVC were 47.0% and 59.4%, respectively (P > 0.05). After non-effective cytoreductive surgery of IPC and IVC groups, the recurrence rates were 84.8% and 86.2%, respectively (P > 0.05). The recurrence time of intraperitoneal tumor of IPC and IVC groups were 24 and 18 months, respectively (P = 0.001). The overall survival time of groups IPC and IVC were 32 and 30 months (P = 0.188). There were some differences in the side-effect between IPC and IVC. The rates of chemotherapeutic phlebitis of IPC and IVC were 34.0% and 10.8% respectively (P < 0.01). The rates of serious gastrointestinal reaction of IPC and IVC were 33.8% and 25.8%, respectively (P = 0.236). There was no significant difference in bone marrow depression, intestinal adhesion and intestinal obstruction. CONCLUSIONS: IPC can extend the disease progression free survival than IVC, without increasing overall survival period. IPC can also reduce the side-effect of chemotherapeutic phlebitis. However, IPC is used limitedly, and can not substitute for IVC. Combination of IPC with IVC may enhance their effectiveness and reduce the side-effects.