| Objective:To explore the recurrence rate,recurrence time and recurrence influencing factors of patients with recurrence and no recurrence after cervical cancer treatment,and plan to provide a reference for the prevention of cervical cancer recurrence.Methods:Cervical cancer patients diagnosed by histopathology in a tertiary oncology hospital in Hunan Province from January 1992 to December2005 were included.All patients to diagnosis as the starting point,all enrolled patients collect the baseline characteristics(including demographic,pregnancy history,clinical pathology,treatment,etc),after the patient discharge by specialized personnel by telephone,letter once a year follow-up,follow-up results include whether the patient recurrence,death,recurrence and the time of death,follow-up time until December31,2010.Descriptive analysis of measurement data and enumeration data was performed as mean ±SD or percentages,respectively.Differences in demographics,maternal history,clinicopathology,and treatment modalities between patients with and without cervical cancer recurrence were examined using t-test or chi-square test.The Kaplan-Meier survival curve was used to draw the stratified recurrence rate curve of cervical cancer patients.The average recurrence time was expressed as the median and interquartile range(IQR),and the log-rank test was used to compare between groups.The multivariate analysis included the variables that were statistically significant in univariate analysis and those that were not statistically significant in univariate analysis but were professionally considered to be significant,and then performed COX proportional hazards regression to calculate the hazard ratio(HR)and 95% confidence interval for cervical cancer recurrence(95%CI).Results:As of the cut-off time of follow-up on December 31,2010,the median follow-up time was 7.4 years(5-19 years),and a total of 4374 cervical cancer patients entered the study cohort,of which 16 were completely lost to follow-up,and the follow-up rate was 99.6%.Finally,4358 cervical cancer patients were included for statistical analysis.Among 4358 patients with cervical cancer,372 cases recurred,and the recurrence rate was 8.5%(95%CI: 7.7%,9.3%).The recurrence rate of cervical cancer patients increased rapidly from 3.8% in the first year to8.0% in the 5th year,and the rate of recurrence slowed down after 5 years,reaching 9.7% and 10.8% in the 10 th and 15 th years,respectively.The recurrence rate curves of patients with age,age at menarche,parity,number of miscarriages,clinical stages,treatment methods and chemotherapy methods were basically the same as the overall recurrence rate.The recurrence rate of patients with different age groups,age at menarche,parity,number of miscarriages,clinical stages,treatment methods and chemotherapy methods were significantly different(P<0.05)(2)The median recurrence time of 372 patients with recurrent cervical cancer was 1.3 years(IQR,0.5-3.3 years).There were significant differences in median recurrence time among patients in different age groups,age at menarche,parity,number of miscarriages,clinical stages,treatment methods,and chemotherapy methods(P<0.05).(3)The results of COX regression analysis showed that after adjusting for confounding factors,patient age,age at menarche,number of miscarriages,clinical stages and treatment methods were independent influencing factors for cervical cancer recurrence.Compared with patients aged <55 years old,patients aged ≥55 years had a relatively low risk of recurrence(HR,0.63;95% CI,0.45-0.89);Compared with patients aged ≤ 15 years at menarche,those aged >15 years had a relatively lower risk of recurrence(HR,0.62;95%CI,0.49-0.80);Patients with ≥ 3 miscarriages had a higher risk of recurrence compared with patients with 0 miscarriages(HR,1.58;95%CI,1.17-2.14);The same compared with patients with clinical stage I,patients with clinical stage II and III/IV had a relatively higher risk of recurrence(HR,1.52;95%CI,1.07-2.16,HR,1.84;95%CI,1.17-2.90);Compared with patients treated with surgery alone,patients treated with surgery plus chemotherapy and chemotherapy alone had a higher risk of recurrence(HR,3.83;95% CI,1.39-10.50,HR,4.60;95% CI,1.35-15.65).Conclusion:(1)The cumulative recurrence rate of 4358 cervical cancer patients was 8.5%,similar to internationally reported levels.The recurrence rate of cervical cancer increased rapidly in the first to fifth year,and the growth trend slowed after the fifth year.The trend of recurrence rate change in different subgroups of cervical cancer patients was basically the same as the overall recurrence rate trend.(2)The median recurrence time of 372 patients with cervical cancer recurrence was 1.3 years,and the recurrence time was short.There was a statistically significant difference in the median time to recurrence of patients in different subgroups.(3)The younger the patient’s age,the earlier the age of menarche,the more abortions,the later the clinical stage,and the treatment methods of surgery + chemotherapy and chemotherapy alone are independent risk factors for cervical cancer recurrence. |
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