침윤성 자궁경부암 환자의 치료전 개복수술후 조직 병리학적 고위험 예후인자에 따른 보조요법

Abstract

Objective : To evaluate the efficacy of postoperative adjuvant therapy was evaluated in preventing treatment failure occurring after primary treatment with surgery in early invasive cervical cancer patients associated with histopathologic high risk factors such as lymph node metastasis, either macroscopic or microscopic, parametrial extension, lymphovascular permeation and depth of invasion ≥10 ㎜. Methods : Postoperative adjuvant concurrent chemoradiotherapy (PCCRT), postoperative adjuvant chemotherapy (PCT) or postoperative adjuvant radiotherapy (PRT) alone was administered to the 80 early invasive cervical cancers with at least one of the high risk factors. Each of 61 patients was received three to six cycles of chemotherapy at about 3-weeks intervals. For squamous cell carcinoma, cisplatin 100 ㎎/㎡ Ⅳ, or paraplatin 350 ㎎/㎡ Ⅳ was infused followed by 5-FU 1000 ㎎/㎡ Ⅳ infusion for 5 days. Twenty three patients were treated with PCCRT, 38 patients were treated with PCT alone. And 19 patients received PRT. Results : The five-year survival rate of patients with macroscopic metastasis was 66.7% and 35.7%, in PCCRT and PRT, respectively. With microscopic lymph node metastasis, the 5-year survival rate was 83.3%, 60.0%, and 70.1% in PCCRT, PCT and PRT, respectively. With parametrial extension, the 5-year survival rate was 58.1% in PCCRT. The five-year survival rate of patients with lymphovascular permeation was 100% 90.9% and 66.7% in PCCRT, PCT and PRT, respectively. With depth of invasion ≥10 ㎜, the 5-year survival rate was 100% and 91.3%, in PCCRT and PCT, respectively. Conclusion : PCCRT appears to be superior to PRT or PCT alone in early invasive cervical cancer patients with histopathologic high risk factors.