Analysis of Efficacy and Prognosis of Radical Surgery Plus Adjuvant Therapy in Patients with Stage Ⅰb2 and Stage Ⅱa2 Cervical Squamous Cell Carcinoma
Objective To analyze the efficacy and prognostic factors of radical surgery combined with or without adju-vant treatment for stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma patients.Methods A retrospective analysis was con-ducted on the medical records of 64 patients with stageⅠb2 and stageⅡa2 cervical squamous cell carcinoma.All patients under-went radical surgery.Determine whether to give adjuvant treatment based on the presence or absence of medium to high-risk fac-tors after surgery,and compared the complications and recurrence rates between the radical surgery +adjuvant treatment group and the simple radical surgery group.After treatment,patients with cervical squamous cell carcinoma were followed up for 3 years and divided into survival group(n =40)and death group(n =24)based on clinical outcomes.General data such as age and body mass index(BMI)were collected,and risk factors affecting the prognosis of cervical squamous cell carcinoma patients in stages Ⅰb2 and Ⅱa2 were analyzed using a multivariate logistic regression analysis model.Results The incidence and recurrence rate of complications in the radical surgery +adjuvant treatment group were lower than those in the simple radical surgery group,and the difference was statistically significant(P<0.05);Univariate analysis showed that age,BMI,clinical stage,degree of pathological differentiation,surgical margin were not associated with the prognosis of cervical squamous cell carcinoma patients(P>0.05),while interstitial infiltration depth,lymph node metastasis,tumor diameter,postoperative adjuvant treatment were associated with the prognosis of cervical squamous cell carcinoma patients(P<0.05);Multivariate logistic regression analysis model analysis shows that the depth of interstitial infiltration is≥1/2(β =3.070,Wald =20.999,95%CI =5.793～80.038),with lymph node metastasis(β =3.045,Wald =18.023,95%CI =5.150～85.634),tumor diameter>4 cm(β =2.996,Wald =19.670,95%CI =5.322～75.160),without postoperative adjuvant treatment(β =1.435,Wald =5.836,95%CI =1.311～13.455)is an indep-endent risk factor affecting the prognosis of cervical squamous cell carcinoma patients(P<0.05).Conclusion Radical surgery combined with adjuvant therapy has a significant effect in patients with stage stage Ⅰb2 and stage Ⅱa2 cervical squamous cell carcinoma,with a low incidence of complications and recurrence.However,factors such as interstitial infiltration depth≥1/2,lymph node metastasis,tumor diameter>4 cm,and lack of adjuvant therapy after surgery are risk factors that affect patient progno-sis.Clinical attention should be paid to these factors and effective prevention and control measures should be actively taken to im-prove patient prognosis.
万方数据
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