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目的:系统评价根治性宫颈切除术治疗早期宫颈癌生存率、复发率及其术后并发症和妊娠情况。方法:应用EndNote软件全面检索Pubmed(1973-2010)数据库,对符合纳入标准的随机对照试验,采用RevMan 4.3软件进行Meta分析。对于无对照临床研究资料,采用同质合并分析。结果:共纳入5篇临床对照研究和14篇无对照临床研究,Meta分析结果显示根治性宫颈切除与全子宫切除治疗早期宫颈癌的生存率差异无统计学意义(P=0.08),而且复发率差异也没有统计学意义(P=0.37),但全子宫切除术后并发症显著高于根治性宫颈切除组(P=0.008)。临床病例系列研究文献统计结果显示早期宫颈癌患者接受根治性宫颈切除术治疗后总的妊娠率达到61%,而复发率仅为2%。结论:根治性宫颈切除治疗早期宫颈癌与全子宫切除术具有相似的肿瘤学结果,术后大部分患者都能成功妊娠。根治性宫颈切除术对于年轻的有生育要求的早期宫颈癌患者是一个安全有效的选择。
Objective: To systematically evaluate the curative effect of radical cervical resection on early cervical cancer survival rate, recurrence rate and postoperative complications and pregnancy. METHODS: The Pubmed database (1973-2010) was searched comprehensively using the EndNote software. Meta-analysis was performed using RevMan 4.3 software in randomized controlled trials that met the inclusion criteria. For uncontrolled clinical study data, homogenous pool analysis was used. Results: A total of 5 controlled trials and 14 uncontrolled clinical trials were included. The results of Meta-analysis showed that there was no significant difference in the survival rates between radical cervical hysterectomy and total hysterectomy for cervical cancer (P = 0.08), and the recurrence rate The difference was not statistically significant (P = 0.37), but the overall hysterectomy complications were significantly higher than those of the radical resection (P = 0.008). Clinical case series literature statistics show that in patients with early cervical cancer after radical cervical resection treatment, the total pregnancy rate reached 61%, while the recurrence rate was only 2%. Conclusion: Radical cervical resection for early cervical cancer and hysterectomy with similar oncology results, most patients after successful pregnancy. Radical cervical resection is a safe and effective option for young patients with early cervical cancer who have fertility requirements.