Analysis Of Clinical And Pathological Factors Of Recurrence Or Uncontrolled After Radical Resection Of Cervical Cancer And Analysis Of Curative Effect Of Retreatment

Objective: To investigate the cliniacal and pathological factors that affect the recurrence or persistence for cervival cancer after radical hysterectomy,For the treatment of cervical cancer to provide a reference.Methods: Retrospectively analyzed from April 2010 to April 2014 Guangxi Medical University Affiliated Tumor Hospital,Department of Oncology,550 cases of IA2-IIB cervical cancer patients in the case data.The clinical,pathologic and follow-up data of all patients were analyzed.SPSS22.0statistical software was used to analyze the data of the cases.A total of 13 clinical and pathological factors were included.The single factor analysis was used to select the significant factors into the Logistic regression model for multivariate analysis.Results :(1)After radical hysterectomy in 550 cases of cervical cancer patients,relapse in patients with 103 cases,accounting for 18.7%.(2)A total of10 clinical and pathological factors including Univariate analysis showed thatthe degree of tumor differentiation,clinical stage,cervical tumor size,depth of cervical tumor invasion,uterine tissue infiltration,vascular thrombosis,lymph node metastasis,surgical margin,preoperative treatment and postoperative adjuvant therapy are related factors of recurrence or persistence after radical hysterectomy for cervical cancer.(3)Multivariate analysis showed that the clinical stage,cervical tumor size,lymph node metastasis,vascular thrombosis,surgical margin,preoperative neoadjuvant chemotherapy and postoperative concurrent chemoradiotherapy A total of 7 clinical and pathological factors are independent factors of recurrence or persistence after radical hysterectomy for cervical cancer.(p <0.05).Among them,the clinical stage of late,cervical cancer ≥ 4cm,lymph node metastasis,vascular thrombosis,positive margin OR values were greater than 1(P> 1),cervical cancer recurrence or persistence after the risk factors;preoperative neoadjuvant chemotherapy,postoperative concurrent chemoradiotherapy OR values were less than 1(P <1),is the cured factors for cervical cancer after radical hysterectomy.Conclusion: Clinical stage of late,cervical cancer ≥ 4cm,lymph node metastasis,vascular thrombosis,positive margin of cervical cancer recurrence or persistence of risk factors.Preoperative adjuvant chemotherapy and postoperative concurrent chemoradiotherapy are beneficial to reduce postoperative recurrence and persistence.Objective: Retrospectively study the re-treated efficacy of recurrence or persistence after radical hysterectomy of cervical cancer,and provide a reference for the treatment of recurrent or persistence cervical cancer after radical hysterectomy.Methods: Retrospectively analyzed from April 2010 to April 2014 Guangxi Medical University Affiliated Tumor Hospital gynecological neoplasms treated 97 cases of IB1-IIB cervical cancer recurrence or persistence after radical hysterectomy in patients with recurrence or persistence of time,the first symptom,recurrence or transfer site,re-treatment methods and efficacy.Results:(1)97 cases of recurrent or persistent cervical cancer patients,45 patients were diagnosed with no symptoms or signs of recurrence or persistence,accounting for 46%;the other 52 patients with common symptoms of vaginal fluid,lumbosacral pain,lower extremity swelling and so on.(2)The recurrence or persistence time of cervical cancer was 1-40 months,the median time was13 months,the average time was 12.0 ± 7.5 months;recurrence or persistence in one year accounted for 49.5%,recurrence and persistence in 2 years accounted for 94.8%;common recurrence or transfer site with pelvic,vaginal stump,bone,liver,lung and so on.(3)The survival time of patients with recurrent or persistent cervical cancer was 2-60 months,the median survival time was 10 months,the average survival time was 13.3 ± 10.4 months.(4)The 1,2,3-year survival rate was 44.1%,16.7% 7.3% in patients with recurrent or persistent cervical cancer after radical hysterectomy.(5)The average survival time of each treatment group was statistically different entirely.The average survival time of the patients in the surgery+ chemoradiotherapy group was better than that in the radiotherapy,chemotherapy group.The average survival time of the patients in the chemoradiotherapy group was better than that in the chemotherapy group.The comparison of median survival time: operation and chemoradiotherapy group> surgery group > chemoradiotherapy group>radiotherapy group >chemotherapy group.(6)On short-term efficacy after re-treatment: The overall efficiency of each treatment group was statistically significant entirely;By pairwise comparison each treatment groups: The effective rate of surgery,radiotherapy,chemoradiotherapy,surgery+chemoradiotherapy groups are better than chemotherapy group.(7)The overall survival rate of each treatment group was statistically different entirely;By pairwise comparison each treatment groups:The survival rate of the surgery +chemoradiotherapy group was better than that of the radiotherapy group,chemotherapy group and chemoradiotherapygroup.The survival rate of the operation group was better than that of the chemotherapy group.The chemoradiotherapy group was better than the chemotherapy group.(8)After vaginal stump recurrence or persistence compare the efficacy of each treatment: The mean survival time、median survival time,and 1,2,and 3 year survival rates were the best in each treatment group after surgery +chemoradiotherapy.(9)After pelvic recurrence or persistence compare the efficacy of each treatment: There were no statistically significant differences in short-term efficacy,and 1,2,and 3-year survival rates between the surgery group,the radiotherapy group,the chemotherapy group and the chemoradiotherapy group.Conclusion:(1)cervical cancer recurrence after less than 2 years,The incidence is hidden,should be followed up closely after surgery.(2)The prognosis of cervical cancer patients with recurrence / persistence after radical hysterectomy is badly.(3)Surgery + chemoradiotherapy is the best treatment for cervical cancer patients with recurrence / persistence after radical hysterectomy.