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Neuroendocrine carcinoma of the cervix: The value of postoperative radiation in early-stage disease

Neuroendocrine carcinoma of the cervix: The value of postoperative radiation in early-stage disease

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目的: 早期子宫颈神经内分泌癌的治疗主要包括手术及化疗;常规术后放疗的应用仍有争议。本研究评估早期子宫颈神经内分泌癌术后放疗的价值。方法:回顾性队列研究,入组2006年-2022年的早期子宫颈神经内分泌癌患者;按术后是否放疗分为术后未放疗组(组A)和术后放疗组(组B)。使用Kaplan-Meier方法计算无进展生存期、总生存期、总生存率。结果: 入组66例患者,组A共32例 (48.5%),组B共34例 (51.5%)。术后随访35 (区间12-116) 个月, 26例 (39.4%) 复发。与组A相比,组B的盆腔复发率略低 (12.5% vs 2.9%, p = 0.142),远处转移率略高 (28.1% vs 44.1%, p = 0.177),总复发率相似 (29.4% vs 31.3%, p = 0.871)。组B的宫颈间质浸润≥1/2更常见 (28.0% vs 63.0%, p = 0.012),此类患者(宫颈间质浸润≥1/2)术后放疗可延长无进展生存期 (33.9个月 vs 47.9个月) 和总生存期 (40.7个月 vs 70.0个月) 但结果无统计学差异 (p = 0.963, p = 0.636)。淋巴脉管间隙受累是术后肿瘤复发的高危因素 (HR 9.13, p = 0.005),但此类患者术后放疗未改善无进展生存期 (51.5个月 vs 48.8个月, p = 0.942) 和总生存期 (53.9个月 vs 60.6个月, p = 0.715) 。研究局限性: 回顾性队列研究,样本量偏小。结论: 早期子宫颈神经内分泌癌术后放疗可改善宫颈间质浸润深度≥1/2患者的无进展生存期和总生存期;淋巴脉管间隙受累是术后肿瘤复发的高危因素,但此类患者术后放疗可能并无生存获益。

Objective: The current treatment for early-stage neuroendocrine carcinoma of the cervix (NECC) mainly relies on operation and chemotherapy. We want to evaluate values of postoperative radiation in early-stage NECC.Methods: Retrospective cohort study. Early-stage NECC patients from 2006 to 2022 in our hospital were included. Depending on whether received postoperative radiation, the patients were divided into Postoperative non-radiation group (Group A) and Postoperative radiation group (Group B). We use Kaplan-Meier method to analyze the progression-free survival (PFS), overall survival (OS), recurrence and OS rate.Results: Sixty-six cases were included, 32 (48.5%) in Group A and 34 (51.5%) in Group B. After 35 (range 12-116) months follow-up, 26 (39.4%) had recurrence. Compared with Group A, Group B had lower pelvic recurrence rate (12.5% vs 2.9%, p = 0.142), higher distant recurrence rate (28.1% vs 44.1%, p = 0.177), and similar mortality rate (29.4% vs 31.3%, p = 0.871). Cervical stromal invasion 1/2 was more common in Group B (28.0% vs 63.0%, p = 0.012). Postoperative radiation in patients with cervical stromal invasion 1/2 showed an extended trend in PFS (33.9 months vs 47.9 months) and OS (40.7 months vs 70.0 months) but without statistical difference (p = 0.963, p = 0.636). Lymph-vascular space invasion (LVSI) is a high-risk factor for tumor recurrence (HR 9.13, p = 0.005), but radiation after surgery did not improve the PFS (51.5 months vs 48.8 months, p = 0.942) and OS (53.9 months vs 60.6 months, p = 0.715) in patients with LVSI.

宋晓晨、杨佳欣、向阳、张卉、钟森、谭先杰、马水清、金滢、潘凌亚、吴鸣、曹冬焱

医药卫生

神经内分泌癌宫颈癌根治性子宫切除术后放疗总生存期.

Neuroendocrine carcinomaCervical cancerRadical hysterectomyPostoperative radiation therapyOverall survival.

宋晓晨,杨佳欣,向阳,张卉,钟森,谭先杰,马水清,金滢,潘凌亚,吴鸣,曹冬焱.Neuroendocrine carcinoma of the cervix: The value of postoperative radiation in early-stage disease[EB/OL].(2025-02-17)[2025-03-14].https://chinaxiv.org/abs/202309.00238.点此复制

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