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摘要:
目的 探讨影响原发性阴道癌预后的临床相关因素。 方法 回顾性分析2003年1月至2015年1月广西医科大学附属肿瘤医院80例阴道恶性肿瘤患者临床资料。80例患者分为放疗组49例，其中二维放疗（two-dimensional radiotherapy 2DRT）组29例、三维放疗（three-dimensional radiotherapy 3DRT）组20例，比较两组的疗效和并发症；手术组31例，其中腹腔镜手术组16例、开腹手术组15例，评估腹腔镜手术在治疗原发性阴道癌中的可行性。 结果 单因素生存分析结果显示FIGO分期、病理类型、肿瘤大小、阴道受侵长度与预后相关（均P＜0.05），Cox多因素分析显示FIGO分期和病理类型为影响阴道癌预后的独立因素。2DRT组5年生存率20.90%与3DRT组的58.60%进行比较，差异具有统计学意义（P=0.022）；2DRT组泌尿系统和消化道并发症的发生率为48.27%（14/29）和51.72%（15/29），分别与3DRT组的15.00%（3/20）和20.00%（4/20）进行比较，差异具有统计学意义（均P＜0.05）。开腹手术组平均住院（57.00±41.75）天，多于腹腔镜手术组的（29.56±7.3）天，两组比较差异具有统计学意义（P=0.024）。 结论 三维放疗及腹腔镜手术的应用，在未降低患者生存率同时可降低并发症，改善患者的生存质量。 Abstract:Objective To evaluate prognosis factors of primary vaginal cancer. Methods Data of 80 patients who were hospitalized in the Department of Gynecology and Oncology of Guangxi Tumor Hospital from January 2003 to January 2015 were retrospectively analyzed.All the patients were divided into radiotherapy group(n=49) and surpery group(n=31).Based on radiation mode, the patients with radiotherapy were divided into two-dimensional radiotherapy group(n=29) and three-dimensional radiotherapy(3DRT)group(n=20).Prognosis and complications between two subgroups were compared.Surgical patients were divided into laparoscopic surgery group(n=16) and laparotomy surgery group(n=15) with comparing therapeutic feasibility of video-laparoscopic operation and laparotomy for primary vaginal carcinoma treatment. Results Univariate analysis showed that FIGO stage, pathology, tumor size, and extent of vaginal mass involvement were related to prognosis(P < 0.05).Multivariate analysis showed that FIGO stage and pathology were independent prognostic factors.Statistical differences of 5-year survival were significant between 2DRT(20.9%)and 3DRT(58.6%)groups(P=0.022).Incidences of urinary tract(14/29, 48.27%)and gastrointestinal symptoms(15/29, 51.72%)in 2DRT group and in 3DRT(3/20, 15%;4/20, 20%)are different significantly(P < 0.05).Hospitalization days of laparotomy surgery group(57.00±41.75) were significantly longer than that of laparoscopic surgery group(29.56±7.30)(P=0.024). Conclusion Applying laparoscopic surgery and 3DRT improved quality of life without decreasing survival rate of patients with vaginal cancer. -
Key words:
- primary vaginal cancer /
- clinicopathological feature /
- treatment /
- prognosis
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表 1 腹腔镜手术组与开腹手术组的比较
Table 1. Comparison of laparoscopic surgery and laparotomy surgery
表 2 临床病理因素的生存率
Table 2. Survival rates for different clinicopathological features
表 3 影响阴道癌预后的Cox多因素分析
Table 3. Cox multivariate analysis of prognostic factors
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[1] Di Donato V, Bellati F, Fischetti M, et al.Vaginal cancer[J].Crit Rev Oncol Hematol, 2012, 81(3):286-295. doi: 10.1016/j.critrevonc.2011.04.004 [2] Rajaram S, Maheshwari A, Srivastava A.Staging for vaginal cancer[J].Best Pract Res Clin Obstet Gynaecol, 2015, 29(6):822-832. doi: 10.1016/j.bpobgyn.2015.01.006 [3] Frank SJ, Jhingran A, Levenback C, et al.Definitive radiation therapy for squamous cell carcinoma of the vagina[J].Int J Radiat Oncol Biol Phys, 2005, 62(1):138-147. doi: 10.1016/j.ijrobp.2004.09.032 [4] Stock RG, Chen AS, Seski J.A 30-year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities[J].Gynecol Oncol, 1995, 56(1):45-52. doi: 10.1006/gyno.1995.1008 [5] Dixit S, Singhal S, Baboo HA.Squamous cell carcinoma of the vagina: a review of 70 cases[J].Gynecol Oncol, 1993, 48(1):80-87. doi: 10.1006/gyno.1993.1013 [6] Greenwalt JC, Amdur RJ, Morris CG, et al.Outcomes of definitive radiation therapy for primary vaginal cancer[J].Am J Clin Oncol, 2015, 38(6):583-587. doi: 10.1097/COC.0000000000000002 [7] Kim H, Kim H, Houser C, et al.Is there any advantage to three-dimensional planning for vaginal cuff brachytherapy[J]? Brachytherapy, 2012, 11(5):398-401. doi: 10.1016/j.brachy.2011.12.009 [8] Walker JL, Piedmonte MR, Spirtos NM, et al.Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2[J].J Clin Oncol, 2009, 27(32):5331-5336. doi: 10.1200/JCO.2009.22.3248 -
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