Retrospective Analysis Of 1885 Cases Of Cervical Cancer In The Fourth Hospital Of Hebei Medical University

Objective: To summarize the clinical,pathological and follow-up da ta of 1885 cases of cervical cancer in the fourth hospital of Hebei Med ical University,and analyze the influencing factors,postoperative compli cations and auxiliary treatment of cervical cancer.Methods: 1885 cases of cervical infiltrating cancer were diagnosed by histopathology from July 1,2008 to September 30,2015,who were treated by operation in the fourth hospital of Hebei Medical University.The total survival(OS)and progression free survival(PFS)were calcula ted by Kaplan Meier method using spss26.0 statistical software.The log rank test and Cox proportional risk model were used to screen the rele vant factors influencing prognosis.The study of queue was carried out by using tendency score matching.P < 0.05,it was considered to be st atistically significant.Results:1.The total OS of cervical cancer patients after operation in our hospital was 87.4% in 5 years.The PFS was 85.5% in 5 years.2.1244 patients(66.0%)underwent open surgery,the 5-year OS was88.8%,the 5-year PFS was 86.4%,641(34.0%)laparoscopic surgery,the5-year OS was 84.6%,the 5-year PFS was 83.6%.The difference was statistically significant.The total incidence of postoperative complications was 16.1%.The incidence of postoperative complications was 14.0% in the laparotomy group and 20.3% in the laparoscopy group.After propensity score matching,the 5-year OS and 5-year PFS of laparotomy group were higher than those of laparoscopy group,the difference was statistically significant.The incidence of intraoperative and postoperative complications in laparoscopic group was higher than that in open group,and the difference was statistically significant.3.Postoperative adjuvant therapy:(1)436 patients had high risk factors,of which 259(59.4%)received chemoradiotherapy,and the 5-year OS was75.7%;15 cases(3.4%)were treated with radiotherapy,and the 5-year OS was66.7%;106 patients(24.3%)received chemotherapy,and the 5-year OS was65.1%;56 cases(12.8%)were untreated,and the 5-year OS was 54.0%.(2)There were 276 cases with more than two intermediate risk factors,of which19 cases(10.5%)received radiotherapy,and the 5-year OS was 89.5%;86cases(31.2%)received chemotherapy,and the 5-year OS was 88.1%;89 cases(32.2%)were treated with chemoradiotherapy.The 5-year OS was 90.3%;82cases(29.7%)were untreated,and the 5-year OS was 85.0%.(3)There was only one intermediate risk factor in 549 cases,of which 140 cases(25.5%)were untreated,and the 5-year OS was 84.2%;68 cases(12.4%)were treated with radiotherapy.The 5-year OS was 98.5%;136 cases(24.8%)received chemotherapy,and the 5-year OS was 86.8%;205 cases(37.3%)were treated with chemoradiotherapy.The 5-year OS was 94.1%.(4)There were 624 cases without risk factors,of which 448 cases(73.4%)were untreated,and the5-year OS was 96.1%;23 cases(3.7%)received radiotherapy,and the 5-year OS was 95.7%;87 cases(13.9%)received chemotherapy,and the 5-year OS was 91.6%;66 cases(12.0%)were treated with chemoradiotherapy.The5-year OS was 87.5%.4.83 cases(29.2%)recurred within 1 year,182 cases(64.1%)within 2years,245 cases(86.3%)within 3 years,265 cases(93.3%)within 4 years and277 cases(97.5%)within 5 years.Conclusions:1.The 5-year OS of cervical cancer patients after operation in our hospital was 87.4%.The 5-year PFS was 85.5%.2.Surgical approach,clinical stage,pathological type,double appendectomy,vascular tumor thrombus,deep muscle invasion,parametrial invasion and lymph node metastasis were independent risk factors for the prognosis of cervical cancer.3.The prognosis of laparotomy group was better than that of laparoscopy group,the 5-year OS and PFS were higher,and the incidence of intraoperative and postoperative complications was lower.4.The adjuvant treatment of cervical cancer after operation has the situation of over treatment or under treatment.The prognosis of patients with high risk factors after operation is better;The prognosis of patients with more than two intermediate risk factors was better;Only one moderate risk factor had a better prognosis.5.The recurrence of cervical cancer mainly occurred within 3 years after operation.6.The 5-year OS of local recurrence group was the highest,followed by distant isolated recurrence group,and finally multiple metastasis group.