影響早期子宮頸腺癌及腺鱗癌預後之病理因子：臺北榮民總醫院10年經驗

Assessment of outcomes in patients with early-stage cervical adenocarcinoma and adenosquamous carcinoma:10-year experiences from Taipei Veterans General Hosital

探討早期子宮頸腺癌及腺鱗癌手術後影響預後之病理因子，並分析術後輔助治療是否影響存活。在2001年1月至2011年12月期間，臺北榮民總醫院婦產部實施子宮根除合併骨盆腔淋巴結切除及主動脈旁淋巴結採樣手術的第一期與第二期之子宮頸腺癌及腺鱗癌75位病人。分析淋巴結轉移、手術切除邊緣、子宮旁組織、巨大腫瘤、子宮頸間質組織、血管淋巴管有癌細胞等。發現病人存活都沒有顯著性差異，只有癌細胞分化程度稍具有差異性之意義。

Background: To investigate the prognostic factors and the impact of adjuvant therapy on survival in patients with early-stage cervical adenocarcinoma and adenosquamous carcinoma. Materials and methods: Patients with stage I-II cervical adenocarcinoma and adenosquamous carcinoma who underwent radical hysterectomy with pelvic lymphadenectomy and para-aortic lymph node sampling as a primary treatment at Taipei VGH from January 2001 through December 2011 were included in this study. The surgical-pathologic factors evaluated in this study include histology, grade of differentiation, primary tumor size, depth of stromal invasion, lymph-vascular space invasion, pelvic lymph nodal metastases, parametrium involvement and surgical margin. Results: All pelvic lymph nodal metastases, positive surgical margin, parametrium involvement, big tumor size, deep stromal invasion, and lymphvascular space invasion did not have effect on survival. Grade 3 differentiation had marginal effect on overall survival (p=0.05). Conclusions: The analysis of prognostic factors demonstrated that only grade of differentiation had effect on overall survival. There was no significant difference in survival in patients with adjuvant therapy after primary surgical treatment. Because of small sample size and retrospective study, we hope to have a randomized prospective study to give us more information.