重新评估淋巴结转移的宫癌的预后因素:基于FIGO 2018的日本多中心队列研究
Kohei Hamada1, Koji Yamanoi2, Nobutaka Hayashi3
1Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
International journal of clinical oncology
|January 15, 2025
概括
2018年FIGO宫癌分期系统将淋巴结转移 (LNM) 分类为IIIC阶段,影响预后. 副大动脉LNM (IIIC2) 表示比盆腔LNM (IIIC1) 更糟糕的结果,这是受局部瘤因素的影响.
科学领域:
- 妇科瘤学 妇科瘤学
- 癌症的分期 癌症的分期
- 临床研究 临床研究
背景情况:
- 2018年国际妇科和产科联合会 (FIGO) 阶段系统修订了宫癌分类,将淋巴结转移 (LNM) 引入为独立的IIIC阶段.
- 这项多中心研究验证了FIGO 2018分类在日本患者队列中的预后意义.
研究的目的:
- 评估FIGO 2018宫癌分期系统的预后影响.
- 为了评估淋巴结转移位置 (盆腔与副大动脉) 对患者结局的影响.
主要方法:
- 对1468名宫癌患者的回顾性分析.
- 根据FIGO 2018标准重新确定最初的FIGO 2009案件.
- 基于LNM位置,局部瘤阶段和组织学的IIIC阶段亚组 (IIIC1与IIIC2) 的比较.
主要成果:
- 27.4%的患者被升级到FIGO 2018阶段IIIC,预后比II阶段更差,比IIIAB阶段更好.
- 第IIIC2阶段 (准大动脉LNM) 的预后明显差于第IIIC1阶段 (盆腔LNM).
- 在IIIC1阶段内的预后因局部瘤阶段而有所不同,而IIIC2阶段的细分结果均为差. 在多变量分析中,Para-aortic LNM,腺癌/腺质组织学和T3AB瘤是显著的独立预后因素.
结论:
- 2018年FIGO分类,特别是将准大动脉LNM区分为IIIC2阶段,对于预测日本患者宫癌预后具有临床意义.
- 在IIIC1阶段内预后分层需要考虑局部瘤特征和组织学亚型.
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