Comprehensive Treatment and Prognostic Factors in Patients with Carcinoma of the Cervical Stump

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OBJECTIVE To evaluate the applicability of combined therapyand the prognostic factors in patients with carcinoma of thecervical stump (CCS).METHODS The clinical records of 60 CCS patients whounderwent combined treatment in our hospital during a periodfrom January 2000 to December 2007, were collected andretrospectively analyzed. The prognostic factors were studiedusing univariate analysis. Analytical evaluation of the independentprognostic factors was performed using COX proportionalhazardsregression model.RESULTS The 1-, 3- and 5-year survival rates of the 60 patientswere 95%, 78% and 68%, respectively, with a median survivaltime of 32 months. Univariate survival analysis showed thatthese independent prognostic factors included positive pelviclymph nodes (P = 0.001), lymphovascular tumor embolus (P =0.001), and adjuvant chemotherapy (P = 0.011). In the 60 cases,postoperative local recurrence in the pelvic cavity occurred in1 and distant metastasis in 3. Related complications, such asradiocystitis, recto-vaginal fistula and vesico-vaginal fistula werefound in 6 of the total cases (10%). The serum levels of squamousepithelium antigen detected before and after treatment weresignificantly different (P = 0.000). The incidence of CCS is low;however, the disease is difficult to cure due to the high incidenceof complications and to the frequency of distant metastasis.Therefore, individualized treatment is needed. Complications fromsubtotal hysterectomy (STH) should be treated and controlledaggressively. Careful follow-up as well as close monitoring andobservation for significant symptoms in the postoperative coursewill enhance clinical outcome.CONCLUSION Cancer of the cervical stump has a lowmorbidity and severe complications, and most recurrences aredistant metastases. Because it is difficult to cure, there is a needto design a treatment regimen for each individual patient basedon the factors deemed as high risk. The surgical indications forsubtotal uterine resection should be followed and close follow-upafter surgery should be maintained. OBJECTIVE To evaluate the applicability of combined therapy and the prognostic factors in patients with carcinoma of thecervical stump (CCS). METHODS The clinical records of 60 CCS patients whounderwent combined treatment in our hospital during a period from January 2000 to December 2007, were collected andretrospectively analyzed. The prognostic factors were studied using univariate analysis. Analytical evaluation of the independent prognostic factors was performed using COX proportional hazards models .RESULTS The 1-, 3- and 5-year survival rates of the 60 patientswere 95%, 78% and 68%, respectively, with a median survival time of 32 months. Univariate survival analysis of showed that the independent independent prognostic factors included positive pelvic lymph nodes (P = 0.001), lymphovascular tumor embolus (P = 0.001), and adjuvant chemotherapy (P = 0.011) recurrence in the pelvic cavity occurred in1 and distant metastasis in 3. Related complications, such asr The serum levels of squamousepithelium antigen detected before and after treatment weresignificantly different (P = 0.000). The incidence of CCS is low; however , the disease is difficult to cure due to the high incidence of complications and to the frequency of distant metastasis. Beforefore, individualized treatment is needed. Complications fromsubtotal hysterectomy (STH) should be treated and controlledaggressively. Careful follow-up as well as close monitoring andobservation for significant symptoms in the postoperative course of enhancing clinical outcome. CONCLUSION Cancer of the cervical stump has a lowmorbidity and severe complications, and most recurrences are distant metastases. Because it is difficult to cure, there is a need to design a treatment regimen for each individual patient basedon the factors deemed as high risk. The surgical indications forsubtotal uterine resection should be followed and close follow-up after surgery should be maintained.
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