| Citation: |
CHEN Dandan, YANG Zhijun, ZHAO Bingbing, ZHANG Jieqing, GAO Kun, WANG He, LI Li. Surgery and Neoadjuvant Chemotherapy After Surgery on Surgical-pathologic Staging in Clinical ⅠB-ⅡB Period Cervical Cancer Patients[J]. Cancer Research on Prevention and Treatment, 2017, 44(7): 465-471. DOI: 10.3971/j.issn.1000-8578.2017.16.1440
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To discuss the feasibility and importance of clinical staging and surgical-pathological staging in the treatment on stagesⅠB-ⅡB cervical cancer.
We retrospectively analyzed the clinicopathological data of 388 patients with stagesⅠB-ⅡB cervical cancer who accepted surgical treatment. These patients were divided into preoperative neoadjuvant chemotherapy group (NACT group) and direct surgery group (DS group). The differences of the results were observed.
For surgical-pathological and clinical staging, the total coincidence rates were 21.1% in DS groups and 10% in NACT groups. For vaginal invasion, the sensitivity, specificity and accuracy were 66.7%, 67.5%, 67.4% in DS group and 50.0%, 58.0%, 57.6% and in NACT group; For parametrial invasion, the sensitivity, specificity and accuracy were 20.0%, 70.9%, 69.7% in DS group and 85.7%, 46.0%, 47.6% in NACT group respectively. The deep stromal invasion and vaginal invasion showed the distinct difference between each stage in DS group(P < 0.05). Tumor emboli could affect the prognosis in pTNM staging of DS group (DFS: P=0.013, OS: P=0.004); but in FIGO staging, staging was closely related to the prognosis (DFS: P=0.024, OS: P=0.050). In NACT group, the staging affected the recurrence(P=0.023), while lymph node metastasis was closely related to the prognosis (DFS: P=0.004, OS: P=0.044).
With an obvious difference between surgical-pathological and clinical staging in stagesⅠB-ⅡB cervical cancer. There is a high percentage of discrepancy in clinical stage ⅡB. Due to the over-staging, many patients in clinical stage ⅡB lose the opportunities of surgery.
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