Analysis Of Current Status Of Adjuvant Treatment For Cervical Cancer In Some Hospitals In My Country In The Past 13 Years

Objective:To investigate and analyze the status and influencing factors of adjuvant treatment of cervical cancer after radical operation in some hospitals in China to improve the standardization of postoperative treatment of cervical cancer in accordance with China’s national conditions and provide reliable clinical data.Methods:A retrospective analysis was performed on 46,313 patients with cervical cancer in some hospitals in China from 2004 to 2016.Among them,33,758 patients required radical surgery for cervical cancer.According to the inclusion and exclusion criteria of this study,a total of 18,384 patients were selected.According to the 2020 NCCN guidelines,they were divided into high-risk group(≥1 high-risk factor),intermediate-risk group(≥2intermediate-risk factors),and low-risk group(1 intermediate-risk factor or no risk factor)according to postoperative pathological risk factors),In order to investigate the relevant influencing factors of adjuvant therapy,and then the low-risk component layer,usingχ~2test,Fisher exact probability method and Logistic regression analysis model for single and multi-factor analysis,according to the three groups of adjuvant therapy,the proportion of different This study mainly analyzed the independent influencing factors of sequential radiotherapy and chemotherapy in the high-risk group,and the independent influencing factors of chemotherapy alone in the medium and low-risk group.Results:1.The incidence of cervical cancer in Chinese women is more common at41-50 years,followed by 51-60 years;mainly concentrated in rural areas;more common in women who have had children;more common in early cervical cancer;squamous cell carcinoma as the main pathological type;The histological grade is mainly of medium and low differentiation;and it is increasing year by year.The proportion of postoperative adjuvant treatment is59.3%.2.Postoperative adjuvant treatment:The proportion of patients in the high-risk group using sequential chemoradiotherapy was as high as 38.9%,while the concurrent chemoradiotherapy accounted for only 9.0%;the patients in the intermediate-risk group were mainly treated with radiotherapy and/or chemotherapy 63.1%;The majority of patients in the low-risk group used non-adjuvant treatment.3.High-risk group is more common with 1 high-risk factor,mainly with only positive lymph node metastasis(88.5%);in the intermediate-risk group,78.3%are mainly with 2 intermediate-risk factors(among which TD≥3cm and DSI≥outer 1/3,accounting for 43.6%);in the low-risk group,it is more common to have one intermediate risk factor,of which adenocarcinoma and adenosquamous carcinoma account for 55.2%.4.A univariate analysis of postoperative adjuvant therapy showed that age was significantly related to postoperative adjuvant therapy in the high-risk group,intermediate-risk group,and low-risk group(P<0.05),and age was the independent risk of postoperative adjuvant therapy in the intermediate-risk group and low-risk group Factors(P<0.05),indicating that age is closely related to postoperative adjuvant treatment of cervical cancer.5.In the high-risk group,women’s and children’s hospitals and postoperative laparotomy are more commonly used with sequential chemoradiotherapy(OR>1).The independent influencing factors for adjuvant treatment in the intermediate-risk group are 6(year,age,hospital type,organization Study type,surgical method and FIGO stage)(P<0.05);in the low-risk group,differentiated cervical cancer,open surgery and patients aged≥60 years were more treated with adjuvant therapy(OR<1).Conclusions:1.The current status of adjuvant treatment of cervical cancer in women in China is under-treatment or over-treatment.It is obviously regional and irregular,and is affected by many factors.2.Sequential chemoradiation is the main treatment for high-risk factors after cervical cancer.However,with the passage of time,concurrent radiotherapy and chemotherapy have shown an increasing trend year by year;radiotherapy and/or chemotherapy is the main treatment method for intermediate risk factors,indicating that cervical cancer in my country Adjuvant treatment after cancer surgery gradually tends to be standardized.3.Adjuvant cervical cancer patients with 1 intermediate risk factor or no risk factor after surgery basically meet the NCCN guidelines,but there are still cases of overtreatment.4.The adjuvant treatment of cervical cancer is closely related to the patient’s age.