Current Status Of Adjuvant Treatment For Early Cervical Cancer After Operation In Some Hospitals In Mainland China

Objective:To analyze the current situation of adjuvant therapy for patients with intermediate/high risk factors after early cervical invasive cancer surgery in some hospitals in mainland China and relevant influencing factors,so as to provide clinical data for the discussion of postoperative adjuvant therapy for patients with intermediate/high risk early cervical cancer suitable for China's national conditions.Methods:A retrospective analysis of 10885 cases of early cervical invasive carcinoma patients with moderate/high risk factors after pathological diagnosis of type ?/? hysterectomy in 38 hospitals in 19 provinces and 11provinces in China from 2004 to 2016.According to the postoperative risk factors,the patients were divided into the intermediate risk group and the high risk group,and the general characteristics of the patients were analyzed.According to the adjuvant treatment,5119 cases were screened again and divided into two groups:radiotherapy group and radiotherapy group(medium risk group),radiotherapy and chemotherapy group and radiotherapy plus consolidation chemotherapy group(high risk group subgroup).Univariate analysis was performed by X~2 test or Fisher exact probability method,and multivariate analysis was performed by two-class logistic regression model.The independent influencing factors affecting postoperative adjuvant therapy were obtained.Results:1.Patients with early stage cervical cancer with moderate/high risk factors were mainly concentrated in North China,general hospitals and first-and second-tier cities;women aged 46-69 were more common,and young women?45 years old were 36.9%in high-risk group.38.8%;histological grade was mainly moderate and poorly differentiated;squamous cell carcinoma was the dominant pathological type;transabdominal type ? total hysterectomy was the main surgical method.2.General situation of postoperative adjuvant treatment:70.1%of patients in the intermediate-risk group received postoperative adjuvant treatment,15.5%in the radiotherapy group and 28.7%in the radiotherapy and chemotherapy group.In the high-risk group,83.7%of patients received postoperative adjuvant treatment:47.0%in the chemoradiotherapy group,and6.9%in the chemoradiotherapy+consolidation chemotherapy group.3.Medium risk subgroup(radiotherapy,radiotherapy and chemotherapy):postoperative invasion of deep interstitium with 1 medium risk factor was more common,postoperative invasion of deep interstitium with 2 medium risk factors accounted for 38.7%,in which primary tumor diameter>4cm+deep interstitium invasion was more common.4.Radiotherapy and chemoradiotherapy have been increasing year by year.With 2008 as the boundary,chemoradiotherapy has gradually dominated the adjuvant treatment of patients with intermediate risk factors after early cervical cancer surgery,and its status over time.More and more significant;age,year,region,city grade,histological grade,histology,and number of intermediate risk factors are independent influencing factors for postoperative adjuvant therapy(radiation and radiotherapy)in the intermediate-risk group.5.High-risk subgroup(chemotherapy and chemoradiotherapy+consolidation chemotherapy):single high-risk factors and lymph node positive were common after surgery,and lymph node positive+parametrial infiltration was the most common among the two high-risk factors.6.Since 2004,the radiotherapy and chemotherapy group and the chemoradiotherapy+consolidation chemotherapy group have shown an increasing trend year by year,and chemoradiotherapy is the main adjuvant treatment after surgery,which is more obvious with the change of the year;the year and the region are high-risk group Independent factors affecting adjuvant therapy(chemotherapy and chemoradiotherapy+consolidation chemothe-rapy).Conclusion:1.In China,postoperative adjuvant therapy for middle/high-risk early cervical cancer patients is diverse,and high-risk patients tend to be standardized.2.Postoperative adjuvant therapy for middle/high-risk early cervical cancer patients in China is dominated by radiotherapy and chemotherapy,and its dominant position has become more and more significant since 2008.3.Regional distribution is an independent influencing factor for the choice of different adjuvant treatments for patients with middle/high risk early cervical cancer after surgery.4.Early cervical cancer patients with multiple postoperative risk factors and histological type of adenocarcinoma were more likely to choose radiotherapy and chemotherapy.