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目的探讨Ⅱb期宫颈鳞癌化疗后手术时机的选择。方法对Ⅱb期宫颈鳞癌患者31例静脉化疗二个疗程后进行手术治疗。对完成宫颈癌根治术(广泛性子宫切除+盆腔淋巴结清扫术)的12例和未完成根治术的19例进行回顾性分析。结果根治术完成组化疗二疗程后宫颈旁浸润缩小近45 %,未完成根治术组宫颈旁浸润缩小仅28 %,有显著性差异(P<0.01)。术中主动损伤2例,被动损伤3例。结论Ⅱb期宫颈鳞癌化疗后应在宫旁浸润缩小≥50 %时进行手术治疗,以提高手术根治率。
Objective To investigate the timing of surgery for stage Ⅱb cervical squamous cell carcinoma after chemotherapy. Methods 31 cases of Ⅱc squamous cell carcinoma of the cervix were treated by two courses of chemotherapy after operation. Twelve patients who underwent radical hysterectomy (radical hysterectomy + pelvic lymphadenectomy) and 19 patients who did not complete radical resection were retrospectively analyzed. Results In the radical operation group, the infiltration of cervix reduced by nearly 45% after two cycles of chemotherapy and the cervical margin infiltration decreased by only 28% in the radical operation group (P <0.01). 2 cases of active injury in surgery, 3 cases of passive injury. Conclusion Ⅱb cervical squamous cell carcinoma after chemotherapy should be reduced in the uterine infiltration ≥ 50% surgery to improve the cure rate.