摘要
目的:评估子宫颈高级别神经内分泌癌(HGNECC)术后不同化疗周期对患者3年的无疾病进展生存期(PFS)和总生存期(OS)的影响。方法:收集2015年10月至2020年12月接受手术及术后辅助化疗的HGNECC患者共303例,按照术后辅助化疗周期(4~6个)分为3组:4周期组134例、5周期组11例和6周期组158例。比较3组基线资料差异及化疗周期对3年PFS和OS的影响,分析不同临床及病理因素对患者预后的影响。应用Log-rank检验进行单因素分析及Kaplan-Meier法估计生存曲线,Cox风险评估模型进行多因素生存分析,多角度分析探索影响HGNECC患者局部无复发生存和远处转移生存的相关临床因素。结果:①单因素分析提示3年PFS与肿瘤分期、颈体交界是否阳性、中高危因素个数、化疗周期有关,3年OS与肿瘤分期有关,差异均有统计学意义(P<0.05);②肿瘤分期为ⅠB1期、颈体交界阴性、中高危因素个数为2、化疗6周期患者的3年PFS较长(P<0.05),其他因素对3年PFS无显著影响(P>0.05);③肿瘤分期较早的患者3年OS较长(P<0.05),其他因素对早期HGNECC患者的3年OS无显著影响;④多因素Cox回归分析提示,颈体交界阳性的患者(HR 4.066,95%CI 1.606~10.291)、化疗周期为5周期的患者(HR 4.726,95%CI 1.628~13.719)癌症复发或者死亡的危险性增加(P<0.05)。结论:对于根治性术后的HGNECC患者,术后化疗周期的增加可能对短期内的PFS有益,而对OS无明显影响。
Objective:To evaluate the effect of different chemotherapy cycles on 3-year progression-free survival(PFS)and overall survival(OS)of patients with high-grade neuroendocrine carcinoma of the uterine cervix(HGNECC).Methods:A total of 303 patients with HGNECC who received surgery and postoperative adjuvant chemotherapy from October 2015 to December 2020 were collected.All the enrolled patients were divided into 3 groups according to the postoperative adjuvant chemotherapy cycle(4-6 cycles):134 cases in the 4-cycle group,11 cases in the 5-cycle group and 158 cases in the 6-cycle group.The difference of baseline data and the influence of chemotherapy cycle on 3-year PFS and OS were compared among the three groups,and the influence of different clinical and pathological factors on the prognosis of patients wereanalyzed.Log-rank test was used for univariate analysis and Kaplan-Meier method to estimate the survival curve.Cox risk assessment model was used for multivariate survival analysis to explore the clinical factors influencing the local recurrence free survival and distant metastasis survival of HGNECC patients.Results:①Univariate analysis showed that 3-year PFS was associated with tumor stage,whether the cervix-body junction was positive,number of medium and high risk factors,and chemotherapy cycle.3-year OS was related to tumor stage,and the difference was statistically significant(P<0.05);②The 3-year PFS of patients withⅠB1 tumor stage(P<0.05),negative cervix body junction(P<0.05),2 medium and high-risk factors(P<0.05),and 6 cycles of chemotherapy was longer(P<0.05),and other factors had no significant effect on the 3-year PFS(P>0.05);③The 3-year OS of patients with early tumor stage was longer(P<0.05),and other factors had no significant effect on the 3-year OS of patients with early cervical HGNECC;④Multivariate Cox regression analysis showed that patients with positive cervix body junction(HR 4.066,95%CI 1.606-10.291)and patients with 5 chemotherapy cycles(HR 4.726,95%CI 1.628-13.719)had an increase
作者
孙雪雨
赵倩
郭瑞霞
王静璐
马姝琦
ZHAO Qian(Department of Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450052,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2022年第7期549-554,共6页
Journal of Practical Obstetrics and Gynecology
关键词
子宫颈高级别神经内分泌癌
依托泊苷
顺铂
术后辅助化疗周期
High-grade neuroendocrine carcinoma of the uterine cervix
Etoposide
Cisplatin
Postoperative adjuvant chemotherapy cycles
