Gruczołowy rak szyjki macicy leczony operacyjnie – czynniki prognostyczne i wyniki leczenia

• Authors: Maciej Bodzek , Wiktor Szatkowski , Marek Jasiówka , Kazimierz Karolewski , Małgorzata Klimek

Title variants

EN

Cervical adenocarcinoma managed with surgery – prognostic factors and treatment outcomes 1

• Languages of publication: EN PL

Abstracts

EN

Aim of the study: Analysis of prognostic factors and treatment outcomes in patients with adenocarcinoma of the cervix treated by surgery. Material and methods: Data of 120 cervical adenocarcinoma patients treated in years 1985–2007 at the Department of Gynecologic Oncology of the Cancer Center, Division in Krakow were analyzed in detail. All patients were treated with primary surgery. The results of combination therapy were evaluated at the first follow-up appointment (6 weeks – 3 months) after completing adjuvant radiotherapy, based on a clinical examination and imaging tests. Progression-free survival and the 5-year survival rate were assumed as the criteria to evaluate the effectiveness of therapy. Survival probability was calculated with Kaplan–Meier estimate. Peto’s log-rank test was used to determine the statistic significance of the obtained differences, and the Cox hazard model was applied to assess the impact of given risk factors on patient mortality. Results: The 5-year survival rate in the group of 120 cervical adenocarcinoma patients was 74.3%. Thirty-two patients (26.6%) suffered a relapse. The average progression-free survival was 24.6 months, and median progression-free survival – 27 months. Multivariate analysis demonstrated a statistically significant detrimental effect of menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes on overall survival. Conclusions: Primary surgery is an effective method of treatment for patients with stage IA and IB cervical adenocarcinoma. Multivariate analysis showed a negative impact on overall survival of the following factors: menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes.

PL

Cel pracy: Analiza czynników prognostycznych oraz wyników leczenia chorych z gruczołowym rakiem szyjki macicy leczonych operacyjnie. Materiał i metody: Szczegółowej analizie poddano grupę 120 pacjentek z gruczołowym rakiem szyjki macicy leczonych w latach 1985–2007 w Klinice Ginekologii Onkologicznej Centrum Onkologii, Oddział w Krakowie. Wszystkie chore poddano pierwotnie leczeniu operacyjnemu. Wyniki leczenia skojarzonego oceniano podczas pierwszej kontroli (od 6 tygodni do 3 miesięcy) po zakończeniu uzupełniającej radioterapii na podstawie badania klinicznego i badań obrazowych. Jako kryterium oceny skuteczności leczenia przyjęto czas do progresji choroby oraz przeżycia 5-letnie. Prawdopodobieństwo przeżycia oszacowano metodą Kaplana–Meiera. W celu oceny istotności statystycznej prezentowanych w wynikach różnic posłużono się testem log-rank według Peto, a w celu oceny wpływu czynników na ryzyko zgonu – modelem hazardu Coxa. Wyniki: Odsetek przeżyć całkowitych 5-letnich w grupie 120 chorych z gruczołowym rakiem szyjki macicy wyniósł 74,3%. U 32 pacjentek (26,6%) wystąpił nawrót choroby nowotworowej. Średni czas do progresji wyniósł 24,6 miesiąca, a mediana czasu do progresji – 27 miesięcy. Analiza wielocechowa wykazała znamienny statystycznie negatywny wpływ menopauzy, chorób współistniejących, zajęcia naczyń limfatycznych i krwionośnych oraz przerzutów do węzłów chłonnych miednicznych na czas przeżycia całkowitego. Wnioski: Pierwotne leczenie chirurgiczne jest skuteczną metodą leczenia chorych z gruczołowym rakiem szyjki macicy w stopniach IA i IB. W analizie wieloczynnikowej niekorzystny wpływ na przeżycia mają: obecność menopauzy, choroby współistniejące, zatory z komórek raka w naczyniach limfatycznych oraz przerzuty w węzłach chłonnych miednicy mniejszej.

Keywords

EN

operacja; radioterapia; rak szyjki macicy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Current Gynecologic Oncology
• Year: 2017
• Volume: 15
• Issue: 1
• Pages: 68–77

Contributors

author

Maciej Bodzek

• Oddział Położniczo-Ginekologiczny, Szpital Powiatowy w Chrzanowie, Chrzanów, Polska

author

Wiktor Szatkowski

• Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Kraków, Polska

author

Marek Jasiówka

• Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Kraków, Polska

author

Kazimierz Karolewski

• Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Kraków, Polska

author

Małgorzata Klimek

• Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Kraków, Polska

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• Document Type: article