Retrospective Analysis Of The Effects Of Different Stages Of 2018 FIGO On The Survival Of Patients With Cervical Cancer

Objective: The effect of new staging on the prognosis of patients with cervical cancer was analyzed retrospectively,and the prognostic prediction ability of staging system was evaluated,so as to provide clinical basis for improving the ability of staging prediction.Methods: The clinical data of 519 patients with cervical cancer diagnosed in our hospital from January to December 2014 were collected.Cox regression analysis was used to compare the effects of sub-stages of stage IB and stageⅢ on the prognosis of patients with cervical cancer.StageⅢC1 patients were stratified at risk,proposed staging adjustment plan,and evaluated the ability of staging system to predict prognosis.Results:(1)The 5-year survival rates of patients with IB1,IB2 and IB3 were 96.9%,89.8% and 76.0%,respectively,and the difference was statistically significant(P=0.013).The mortality risk ratio of patients with IB2 stage was 3.459 times higher than that of patients with IB1 stage,and the death risk ratio of patients with IB3 stage was 5.557 times higher than that of patients with IB1 stage,but the difference was not statistically significant(HR=3.459、5.557,P>0.05).(2)The overall survival rates of patients with stage IIIC1 diagnosed by imaging and pathology were 83.3% and 79.4%,respectively,and the difference was not statistically significant(P=0.849).(3)Comparing the prognostic effects of different sub-stages of stage Ⅲ,it was found that the risk of death in patients with stage IIIC1 was 1.721 times higher than that in patients with stage IIIAB(HR=1.721,P>0.05),and the risk of death in patients with stage IIIC2 was 5.169 times higher than that in patients with stage IIIAB(HR=5.169,P<0.05).(4)The patients with stage IIIC1 were divided into groups according to the size of the tumor.The results showed that the group of stage IIIC1(≥8 cm)had the worst prognosis,and the risk of death in the group of stage IIIC1(≤4 cm)was 4.143 times higher than that in the group of stage IIIC1(≤4 cm)(HR=4.143,P> 0.05).(5)According to the tumor size adjustment staging standard,there was significant difference in the area under the ROC curve between the adjusted staging and the 2018 staging(AUC was 0.617 and 0.528 respectively).Conclusion: Although the increase of sub-staging in stage IB is beneficial to shunt treatment,it can not clearly distinguish the survival of each sub-staging.According to the tumor size adjustment staging system of stage IIIC1,the ability to predict prognosis can be better improved,so the effect of tumor size on the survival of patients with stageⅢC1 should be considered in the future.