摘要
目的 系统评价盆腔廓清术在复发性子宫颈癌治疗中的现状及患者的预后.方法 检索中国生物医学文献数据库（CBM）、PubMed数据库和Cochrane图书馆数据库自1990年1月至2013年8月间全部关于复发性子宫颈癌行盆腔廓清术的文献,筛选出符合纳入标准的文献进行循证评价,内容包括患者的基本资料、手术相关资料及并发症和生存情况,并对影响患者预后的因素进行分析.本研究的纳入标准为：复发性子宫颈癌,临床随机对照试验、前瞻性非随机对照试验、回顾性病例对照研究及队列研究,研究中应有具体的患者基本资料及手术相关资料、生存率结果,外文文献仅限于英文文献.结果 本研究纳入8篇文献,共有607例子宫颈癌患者接受盆腔廓清术,其中复发性子宫颈癌患者515例,有3篇文献中还包括初治的原发性子宫颈癌患者92例.接受全盆腔廓清术、前盆腔廓清术、后盆腔廓清术的患者分别为490、103及14例.复发性子宫颈癌患者盆腔廓清术后的5年总生存率为26.7％～56.0％,手术并发症发生率为34.3％ ～ 83.3％,术后病死率为1.2％（7/607）.手术切缘是否阳性是影响患者生存时间的最重要因素.结论 选择合适的复发性子宫颈癌患者行盆腔廓清术能明显延长患者的生存时间.
Objective To evaluate the current status and outcomes of pelvic exenteration （PE） for recurrent cervical cancer.Methods The following electronic databases has been searched on recurrent cervical cancer management and treatment：Chinese Biological Medicine Disk （CBM）,PubMed and Cochrane library.All retrieved studies had to fulfill the following inclusion criteria：cohort studies of recurrent cervical cancer,containing information of detailed patient and operation characteristics as well as the survival rate.Only publications in the English literature were included.All eligible literatures between Jan.1990 and Aug.2013 were assessed for quality.Relevant basic characteristics,complications,survival rate and prognostic factors were reviewed.Results There were eight trials involving 607 patients with cervical cancer received PE,including 515 cases with recurrent disease and 92 cases with primary disease.Four hundred and ninety patients had received total pelvic exenteration （TPE） operation,103 underwent anterior pelvic exenteration（APE） and 14 received posterior pelvic exenteration（PPE）.The 5-year overall survival rate for recurrent cervical cancer fluctuate from 26.7% to 56.0%.Complication rates were from 34.3% to 83.3% and the mortality rate was 1.2% （7/607）.Among the relevant factors affecting survival time,resection margin status seemed to be the most important.Conclusion Based on this systematic review,PE does help improve the survival of recurrent cervical cancer patients on the basis of strict selection of candidates.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2014年第6期460-465,共6页
Chinese Journal of Obstetrics and Gynecology
关键词
宫颈肿瘤
肿瘤复发
局部
盆腔廓清术
预后
Uterine cervical neoplasms
Neoplasm recurrence, local
Pelvic exenteration
Prognosis
