Zhonghua yi xue za zhi · 2016
[Clinical analysis of ovarian metastasis in patients with Ⅰb stage cervical adenocarcinoma].
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Lu Huaiwu, Chen Hao, Liu Yunyun, Wang Dongyan, Xu Guocai, Lin Zhongqiu
Аннотация
OBJECTIVE: To investigate the rate of ovarian metastasis and its related factors in patients with cervical adenocarcinoma, and explore whether the ovary should be reserved or not in cervical adenocarcinoma.
METHOD: The clinical data of 111 patients with cervical adenocarcinoma who received extensive total hysterectomy plus pelvic lymph node resection in Sun Yat-sen Memorial Hospital and Quanzhou Women's and Children's Hospital from January 2008 to December 2014 were collected and analyzed by single factor χ(2) test and multivariate logistic regression analysis.
RESULTS: The median age of the included 111 cases of cervical adenocarcinoma was 44. Sixty-five of the patients were stage Ⅰb1, while 46 were stage Ⅰb2. The single factor analysis indicated that lymph-vascular space invasion(LSVI), lymph node status, interstitial infiltration depth, parametrial involvement and involvement of cervical body junction were associated with ovarian metastasis. Multivariate analysis indicated that LSVI (HR: 47.01, 95% CI: 2.48-890.03, P=0.010) and lymph node status (HR: 23.58, 95% CI: 1.20-463.21, P=0.038) were independent risk factors for ovarian metastasis.
CONCLUSIONS: Ovarian metastasis rate of stage Ⅰb cervical adenocarcinoma is low; patients with age less than or equal to 45 years old, negative LSVI, <1/2 cervical stromal invasion, no lymph node metastasis and no cervical body junction involvement can consider preservation of ovary; but these findings still need to be further confirmed by large randomized controlled trials.
METHOD: The clinical data of 111 patients with cervical adenocarcinoma who received extensive total hysterectomy plus pelvic lymph node resection in Sun Yat-sen Memorial Hospital and Quanzhou Women's and Children's Hospital from January 2008 to December 2014 were collected and analyzed by single factor χ(2) test and multivariate logistic regression analysis.
RESULTS: The median age of the included 111 cases of cervical adenocarcinoma was 44. Sixty-five of the patients were stage Ⅰb1, while 46 were stage Ⅰb2. The single factor analysis indicated that lymph-vascular space invasion(LSVI), lymph node status, interstitial infiltration depth, parametrial involvement and involvement of cervical body junction were associated with ovarian metastasis. Multivariate analysis indicated that LSVI (HR: 47.01, 95% CI: 2.48-890.03, P=0.010) and lymph node status (HR: 23.58, 95% CI: 1.20-463.21, P=0.038) were independent risk factors for ovarian metastasis.
CONCLUSIONS: Ovarian metastasis rate of stage Ⅰb cervical adenocarcinoma is low; patients with age less than or equal to 45 years old, negative LSVI, <1/2 cervical stromal invasion, no lymph node metastasis and no cervical body junction involvement can consider preservation of ovary; but these findings still need to be further confirmed by large randomized controlled trials.