摘要:
目的:分析原发性阴道恶性肿瘤的治疗方式及预后因素。方法:回顾性分析1988～2000年间天津市肿瘤医院收治的58例原发性阴道恶性肿瘤病例,Ⅰ期11例,Ⅱ期16例,Ⅲ期18例,Ⅳ期13例;鳞癌27例,腺癌18例,其他13例,单纯手术23例,单纯放疗17例,手术加放疗18例。结果:总的5年生存率为51.72%,Ⅰ期72.73%,Ⅱ期62.50%,Ⅲ期55.56%,Ⅳ期15.38%,单纯手术、单纯放疗、手术加放疗疗效无统计学差异(P=0.985),单因素分析示:病理类型(P=0.030)、阴道受侵长度(P=0.025)、临床分期(P=0.022)为预后因素,多因素回归分析示:病理类型(P=0.044)、阴道受侵长度(P=0.023)、临床分期(P=0.012)为独立预后因素。结论:原发性阴道恶性肿瘤治疗应该个体化,以放疗为主,部分病例可行手术治疗。独立预后因素为临床分期、阴道受侵长度、病理类型。
Abstract:
To analyze the treatment method and prognostic variables of primary malignant vaginal tumor. Methods: Data from 58 cases with primary malignant vaginal tumor, treated in our hospital from 1988 to 2000, were reviewed retrospectively. Of these cases, 11 were classified as stageⅠ, 16 as stage Ⅱ, 18 as stage Ⅲ and 13 as stage Ⅳ. Twenty- seven cases were squamous cell carcinomas,18 were adenocarcinomas and 13 were other histological types. There were 3 types of treatment:simple surgery (n=23), radiotherapy alone (n=17) and surgery plus radiotherapy (n=18). Results: The overall 5- year survival rate was 51.72%; that is, the 5- year survival rate was 72.73% for stage Ⅰ disease,62.5% for stage Ⅱ, 55.56% for stage Ⅲ and 15.38% for stage Ⅳ. There was no significant difference between treatment with simple surgery, radiotherapy alone or surgery plus radiotherapy (P=0.985). Univariate analysis showed that the histological type (P=0.030), tumor size (P=0.025) and clinical stage (P=0.022) were prognostic factors, and the multivariate analysis indicated that the histological type (P=0.044), tumor size (P=0.023) and clinical stage (P=0.012) were independent prognostic factors.Conclusion: Treatment of primary malignant vaginal tumor should be individualized, with priority given to radiotherapy as treatment, and then to surgery . The independent prognostic variables include clinical stage, tumor size and histological type.
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