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11.
《European journal of surgical oncology》2022,48(9):2045-2052
IntroductionThe aims of this study were to analyze the pathological response, and survival outcomes of adenocarcinoma/adenosquamous (AC/ASC) versus squamous cell carcinoma (SCC) in patients with locally advanced cervical cancer (LACC) managed by chemoradiotherapy followed by radical surgery.MethodsRetrospective, multicenter, observational study, including patients with SCC and AC/ACS LACC patients treated with preoperative CT/RT followed by tailored radical surgery (RS) between 06/2002 and 05/2017. Clinical-pathological characteristics were compared between patients with SCC versus AC/ASC. A 1:3 ratio propensity score (PS) matching was applied to remove the variables imbalance between the two groups.ResultsAfter PS, 320 patients were included, of which 240 (75.0%) in the SCC group, and 80 (25.0%) in the AC/ASC group. Clinico-pathological and surgical baseline characteristics were balanced between the two study groups. Percentage of pathologic complete response was 47.5% in SCC patients versus 22.4% of AC/ASC ones (p < 0.001). With a median follow-up of 51 months (range:1–199), there were 54/240 (22.5%) recurrences in SCC versus 28/80 (35.0%) in AC/ASC patients (p = 0.027). AC/ASC patients experienced worse disease free (DFS), and overall survival (OS) compared to SCC patients (p = 0.019, and p = 0.048, respectively). In multivariate analysis, AC/ACS histotype, and FIGO stage were associated with worse DFS and OS.ConclusionIn LACC patients treated with CT/RT followed by RS, AC/ASC histology was associated with lower pathological complete response to CT/RT, and higher risk of recurrence and death compared with SCC patients. This highlights the need for specific therapeutic strategies based on molecular characterization to identify targets and develop novel treatments. 相似文献
12.
M. Iachina P.M. Ljungdalh R.G. Sørensen L. Kaerlev J. Blaakær O. Trosko N. Qvist B.M. Nørgård 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):115-123
Aims
To examine the influence of pre-existing psychiatric disorder on the choice of treatment in patients with gynaecological cancer.Materials and methods
The analyses were based on all patients who underwent surgical treatment for endometrial, ovarian or cervical cancer who were registered in the Danish Gynecological Cancer Database in the years 2007–2014 (3059 patients with ovarian cancer, 5100 patients with endometrial cancer and 1150 with cervical cancer). Logistic regression model and Cox regression model, adjusted for relevant confounders, were used to estimate the effect of pre-existing psychiatric disorder on the course of cancer treatment. Our outcomes were (i) presurgical oncological treatment, (ii) macroradical surgery for patients with ovarian cancer, (iii) radiation/chemotherapy within 30 days and 100 days after surgery and (iv) time from surgery to first oncological treatment.Results
In the group of patients with ovarian cancer, more patients with a psychiatric disorder received macroradical surgery versus patients without a psychiatric disorder, corresponding to an adjusted odds ratio of 1.24 (95% confidence interval 0.62–2.41) and the chance for having oncological treatment within 100 days was odds ratio = 1.26 (95% confidence interval 0.77–2.10). As for patients with endometrial cancer, all outcome estimates were close to unity. The adjusted odds ratio for oncological treatment within 30 days after surgery in patients with cervical cancer with a history of psychiatric disorder was 0.20 (95% confidence interval 0.03–1.54).Conclusions
We did not find any significant differences in the treatment of ovarian and endometrial cancer in patients with pre-existing psychiatric diagnoses. When it comes to oncological treatment, we suggest that increased attention should be paid to patients with cervical cancer having a pre-existing psychiatric diagnosis. 相似文献13.
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目的了解我院门诊就诊者对子宫颈病变相关知识的认识。方法自制问卷调查表,采用无记名,当面问卷调查方式。结果从调查100例就诊者中,未做过健康体检、妇科盆腔检查和宫颈刮片检查分别为34例、24例和52例。对宫颈癌的认识不知道者53例。结论建议相关部门加强对妇女的健康教育,提高其健康意识,强化临床医生的防癌意识和对子宫病变的规范化诊治。 相似文献
16.
颈椎后纵韧带骨化症后路术后C5神经根麻痹 总被引:5,自引:1,他引:4
目的:探讨颈椎后纵韧带骨化症(OPLL)术后C5神经根麻痹的临床特点、治疗及预后。方法:2000年3月至2005年1月.采用后路减压手术治疗OPLL患者157例.其中9例术后卅现C5神经根麻痹。回顾性分析9例患者的临床资料,所有患者术后均进行功能康复训练,其中5例患者给予高压氧辅助治疗,随访观察预后情况。结果:本组C5神经根麻痹的发生率为5.7%.包括单开门椎管成形术2例、全椎板切除减压术7例。其临床表现为三角肌、肱二头肌肌力下降至1~2级,肩部及上臂外侧感觉障碍,肱二头肌腱反射减弱或消失。随访1~4年,9例患者的肌力均恢复至3~4级,7例感觉恢复正常。结论:C5神经根麻痹是颈椎后路手术治疗OPLL的并发症之一,经过功能康复训练等保守治疗后肌力、感觉均可获得一定恢复。 相似文献
17.
Distribution patterns of transforaminal injections in the cervical spine evaluated by multi-slice computed tomography 总被引:1,自引:1,他引:0
Transforaminal injections are sometimes used for the diagnosis and treatment of painful conditions in the lumbar and to a lesser degree in the cervical spine. The technique is most often used when investigating/treating radiculopathy caused by degenerative disease. But how selective are the nerve root blocks? What possible structures other than the intended nerve root are affected from such injections? This study was undertaken in order to try to answer these questions, as no study focusing on the possible spread from the transforaminal selective nerve root blocks in the cervical spine has been performed earlier. In three groups of patients, each group including three patients, we injected three different volumes (0.6, 1.1 and 1.7 ml) with a transforaminal technique in the cervical spine. In all the injections, a small amount of contrast media was added. The spread of the injections were then investigated using multi-slice computed tomography with reconstructions. The imaging revealed a possible effect on other nerve roots than the intended ones when a larger volume was used for the root blocks. The spread was related to the injected volume as well as to local anatomy (size of foraminal area). In this study, only 0.6-ml injections could be accepted for being selective enough for diagnostic investigations. 相似文献
18.
项韧带骨化相关因素及其组织学变化 总被引:1,自引:0,他引:1
目的:探讨脊髓型颈椎病患者项韧带骨化的相关因素及其组织学改变特点.方法:将45例脊髓型颈椎病患者根据项韧带有无骨化分为两组,观察并统计两组患者的年龄、性别组成、颈椎椎间退变和颈椎稳定性情况,对各指标与项韧带骨化的关系进行相关性分析,同时观察项韧带骨化的组织学改变.结果:统计分析表明,项韧带骨化和颈椎椎间退行性改变及颈椎不稳定之间具有相关性(P<0.05);同时还与患者年龄、性别组成有相关性(P<0.05).项韧带骨化的组织学改变以软骨内化骨为主.结论:项韧带骨化与颈椎退行性改变及颈椎椎间关节不稳定具有相关性,组织学改变以软骨内化骨为主. 相似文献
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20.
导航系统辅助下颈椎椎弓根螺钉置钉准确性的实验研究 总被引:2,自引:0,他引:2
目的:评价导航系统辅助下颈椎(C3~C7)椎弓根螺钉内固定置钉的准确性.方法:将32具成人尸体颈椎标本随机分为4组,分别采用盲法、透视法、透视导航法和CT导航法进行下颈椎椎弓根螺钉置入.术后采用标本大体解剖观察的方法评价置钉准确性.分优(螺钉完全在椎弓根内)、可(仅有螺纹穿出,对周围组织无损伤)和差(螺钉明显穿出)进行统计.结果:共置入螺钉318枚.盲法80枚,平均手术时间27min,优29枚(36 3%)、可21枚(26.3%)、差30枚(37.5%);透视法78枚(有1例C4、C5右侧椎弓根均细小,不能容纳3.5mm螺钉),平均手术时间112min,优35枚(44.9%)、可29枚(37.2%)、差14枚(17.9%);透视导航法80枚,平均手术时间69min,优34枚(42.5%),可36枚(45%),差10枚(12.5%);CT导航法80枚,平均手术时间98min,优70枚(87.5%)、可10枚(12.5%).各组间手术时间均有显著性差异(P<0.05),透视法与透视导航法的置钉准确率间无显著性差异,其余各组间均有显著性差异(P<0.05).结论:单纯根据术前影像结果盲法行下颈椎椎弓根螺钉内固定不安全.透视法和透视导航法可提高置钉准确性,但手术风险仍较大,透视导航法比透视法置钉的手术时间缩短.CT导航法并未比透视法增加手术时间,但置钉准确性显著提高. 相似文献