|
外阴癌39例手术治疗及预后分析 |
| |
曹冬焱 沈铿 郎景和 黄荣丽 黄惠芳 连利娟
【摘要】 目的 总结我院治疗外阴癌的手术方式；分析与外阴癌预后有关的因素。方法 回顾性分析我院1979～1997年收治的39例侵袭性外阴癌的临床资料，其中外阴病灶局部切除术5例、部分外阴根治术13例及全外阴根治术21例。应用SPSS软件对不同的手术方式和有关预后因素进行比较分析。结果 39例中鳞癌33例，占84.6%，其中高、中、低分化分别为26、5、2例。临床分期为Ⅰ期7例（17.9 %）、Ⅱ期17例（43.6%）、Ⅲ期13例（33.3%）及Ⅳ期2例（5.1%）。Ⅰ、Ⅱ期侧位型肿瘤居多，占58.3%；Ⅲ、Ⅳ期中线型肿瘤居多，占73.3%。病灶局部切除、部分外阴根治及全外阴根治术（外阴病灶、腹股沟切口分开及二者联合切口）的术后住院日依次为9.1、20.6、41.2及62.2 d(P<0.01)；切口感染率依次为0.0、30.8、66.7、88.9%( P<0.01)。Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的中位数生存时间分别为132.0、121.5、67.5及21.5个月(P=0.01)；5年生存率分别为85.7、70.6、46.2及0.0%(P<0.05)。无和有淋巴结受累患者的中位数生存时间分别为121.5个月及66.0个月(P<0.01)；5年生存率分别为71.5%及30.0%(P<0.05)。高分化与中低分化者的平均存活时间分别为97.0个月及64.0个月(P>0.05)，5年生存率分别为62.0%及43.0%(P>0.05)。结论 侵袭性外阴癌的手术方式应根据病情个体化。外阴癌的预后与肿瘤部位、临床分期、组织学分化及是否累及淋巴结密切相关。
【关键词】 外阴肿瘤；外科手术方法，手术的；预后
Surgical Treatment and Prognostic Analysis of 39 Cases Invasive Vulvar Cancer
CAO Dongyan, SHEN Keng, LANG Jinghe, et al.
（Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China）
【Abstract】 Objective To summarize the procedure of operations and evaluate the prognostic factors in the invasive vulvar cancer. Methods Thirty nine cases with invasive vulvar cancer admitted in our hospital from 1979 to 1997 were retrospectively analyzed. Three kinds of operations were used: 5 by local excision, 13 by modified radical vulvectomy and 21 by radical vulvectomy.Statistical package for social sciences (SPSS) was used to compare the different strategy of operation and analyze the prognostic factors. Results Thirty three patients (84.6%) had squamous cell carcinoma and 26 of them (78.8%) were well differentiated and 2 poorly differentiated. Seven cases (17.9%) were in FIGO stage I; 17 (43.6%) in stage Ⅱ; 13 (33.3%)in stage Ⅲ, and 2(5.1%) in stage Ⅳ, 58.3% of tumor in stage Ⅰ and Ⅱ were lateral while 73.3% of tumor in stage Ⅲ and Ⅳ were median type. Hospitalization time for local exci[1] [2] 下一页
上一个医学论文： 表皮生长因子受体在植入前胚胎细胞中的表达
下一个医学论文： 超大剂量化学药物和外周血干细胞移植治疗晚期妇科恶性肿瘤5例分析
|
|
|
|
|
|
|
您现在的位置： 绿色健康网 >> 医学论文 >> 妇产科论文 >> 正文