Poor prognosis of patients with stage ib1 adenosquamous cell carcinoma of the uterine cervix with pelvic lymphnode metastasis
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概要
- 論文の詳細を見る
From January 1990 to December 2004, the prognosis of 28 patients with stage Ib1adenosquamous cell carcinoma (ASC) were assessed in comparison with those ofmatched counterparts of pure adenocarcinoma (ADC) and squamous cell carcinoma(SCC). The mean ages were 46.6, 48.3, and 48.5 years for patients with ASC, ADC,and SCC, respectively. All the patients underwent radical hysterectomy with pelviclymphadenectomy and postoperative adjuvant therapy was given to the patients withpositive pathological risk.The incidence of lymph node metastasis for ASC at 21.4% was not significantlydifferent from those for ADC (13.6%) and SCC (15.8%). There was also nosignificant difference in the incidence of lymphatic or vascular space involvement(LVSI) and depth of stromal invasion between three cell types. Since the tumor sizesof all ASC cases examined in this study were less than 4cm, the prognoses werecompared among stage Ib1 disease according to the classification system of theInternational Federation of Gynecology and Obstetrics (FIGO). The overall 5-yearsurvival rates of stage Ib1 ASC, ADC, and SCC were 82.4%, 92.4%, and 94.0%,respectively, suggesting poor prognosis of ASC, but there was no significant difference.Patients with stage Ib1 ASC were retrospectively assigned to a low- or high-riskgroup based on the surgical-pathologic factors including positive lymph nodemetastasis, 2-4cm of tumor size, positive LVSI, and/or deep stromal invasion. Whileall 9 patients in the low-risk group are alive without disease, 7 of the 19 patients in thehigh-risk group developed recurrence. The overall 5-year survival rates were 100%for a low risk group and 74.8% for a high-risk group, respectively, but this differencedid not reach statistical significance. However, the prognosis of high-risk patientswith lymph node metastasis was significantly (p=0.01) worse than low-risk group. Thepresent study suggests that ASC histology appears to carry a poor prognosis than SCC,but low-risk group of stage Ib1 ASC has a good prognosis without postoperativeadjuvant therapy.
- 神戸大学の論文
著者
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NISHIMURA Ryuichiro
Hyogo Institute of Clinical Research
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Takekida Shigeki
神戸大学医学系研究科
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Takekida Shigeki
Hyogo Medical Center For Adults
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Sugimoto Takeshi
Clinical Research Division Hyogo Medical Center For Adults
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Kojima Atsumi
Clinical Research Division Hyogo Medical Center For Adults
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Sudo Tamotsu
Clinical Research Division, Hyogo Medical Center for Adults
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Sudo Tamotsu
Clinical Research Division Hyogo Medical Center For Adults
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Yasuda Shintaro
Hyogo Medical Center for Adults
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Kojima Atsumi
Hyogo Medical Center for Adults
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Maeno Yoko
Hyogo Medical Center for Adults
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Oki Noriyoshi
Hyogo Medical CeHyogo Medical Center for Adults
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Miyahara Yoshiya
Hyogo Medical Center for Adultsnter for Adults
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Sudo Tamotsu
Hyogo Medical Center for Adults
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Yamaguchi Satoshi
Hyogo Medical Center for Adults
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Nishimura R
Clinical Research Division Hyogo Medical Center For Adults
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Yamaguchi Satoshi
Gynecology And Oncology Division Hyogo Medical Center For Adults
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Takekida Shigeki
Hyogo Medical Center Adults Akashi Jpn
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Sudo Tamotsu
Hyogo Cancer Center
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