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Clinical Analysis of Prognostic Factors in 73 Cases of Cervical Cancer

Author: HeDongZuo
Tutor: YueZuo
School: Jilin University
Course: Clinical
Keywords: Cervical cancer clinical parameter pathological parameter adjuvant chemoradiotherapy prognosis
CLC: R737.33
Type: Master's thesis
Year: 2009
Downloads: 124
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Abstract

Cervical cancer is one of the most common gynecological malignancies. In recent years, the availability of measures have increased the rate of the early diagnosis and reduced the mortality of cervical cancer, such as cervical screening programs, the developing technique of early diagnose, the improving of the surgery and the rationalization of the treatment. However, there are still a lot of patients who have failed their treatments and had a poor outcomes, which remind us to concern the prognostic significance of cervical cancer, and then to establish the most reasonable treatment, strengthen of management and follow up. At present, investigators have evaluated multiple potential prognostic factors of cervical cancer. We would give a research of cervical cancer containing the clinical parameters (age, type of the tumor, stage, tumor size)、pathological parameters (histology, grade, lymph node status)、adjuvant chemoradiotherapy, et al, and analysis the relative factors of pelvic lymph node metastasis in cervical cancer.Object: The purpose of the present study was to identify prognostic factors in surgically treated patients with stageⅠb-Ⅱb cervical cancers, and to see if the adjuvant chemora-diotherapy could raise the survival rate of cervical cancer. Further analysis was done to study the relative factors of the pelvic lymph node metastasis in cervical cancer.Method: Retrospective review of 73 patients from the First Hospital of Jilin University with cervical carcinoma treated surgically between January 2000 and January 2008. Univariate and multivariate statistics was performed to to test the association of prognosis with various factors: age、type of the tumor、stage、tumor size、histology、grade、lymph node status and adjuvant chemoradiotherapy. Further analysis was done to see which factors had relationship with the pelvic lymphatic metastasis and if the adjuvant chemoradiotherapy could raise the survival rate of cervical cancer.Result: 3-year survival rate for all patients was 63.63%. Univariate analysis revealed that age、type of the tumor、histology and grade had no association with survival rates (P>0.05); Stage、tumor size、lymph node status and Adjuvant chemoradiotherapy was associated with patients’prognosis (P<0.05). In Multivariate analysis, type of the tumor、Stage、tumor size and lymph node status was the independent prognostic factor for patients (P<0.05), while other factors were not. We also founded no association between the pelvic lymphatic metastasis and the factors, such as age、type of the tumor、stage、tumor size、histology、grade (P>0.05).Conclusion: 1. Stage、tumor size、lymph node status and Adjuvant chemoradiotherapy was the significant prognostic factor for patients in univariate analysis; in multivariate analysis, type of the tumor、Stage、tumor size and lymph node status was the independent predictor of outcome. 2. The patients with obturator、hypogastric、external iliac lymphatic metastasis had a poorer outcomes than patients with no lymphatic metastasis; patients with common iliac、inguinal lymph nodes metastasis had a high rate of relapse and mortality; 3. postoperative radiotherapy and chemoradiotherapy can raise patients’survival rate, the curative effect of the former was better than the latter; 4. age、type of the tumor、tage、tumor size、histology、grade had no association with pelvic lymphatic metastasis.

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