572例宫颈癌远处转移患者的转移特征及生存分析：以医院为基础的真实世界研究

沈洁; 冯小双; 温灏; 周昌明; 莫淼; 王泽洲; 袁晶; 吴小华; 郑莹

doi:10.19401/j.cnki.1007-3639.2024.04.003

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572例宫颈癌远处转移患者的转移特征及生存分析：以医院为基础的真实世界研究

专题论著 | 更新时间：2025-12-31

- 572例宫颈癌远处转移患者的转移特征及生存分析：以医院为基础的真实世界研究
- Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study
- 中国癌症杂志 2024年34卷第4期页码：361-367
- 作者机构：
  
  1. 复旦大学附属肿瘤医院肿瘤预防部，复旦大学上海医学院肿瘤学系，上海 200032
  2. 复旦大学附属肿瘤医院肿瘤妇科，复旦大学上海医学院肿瘤学系，上海 200032
- 作者简介：
  
  [ "沈洁（ORCID: 0000-0003-2504-4491），主管医师。" ]
  [ "郑莹，复旦大学附属肿瘤医院肿瘤预防部主任，主任医师，教授，硕士研究生导师。长期从事肿瘤预防控制工作。开展肿瘤病因和预后研究，建立起了以人群为基础的乳腺癌患者队列和大肠癌筛查人群队列。执笔《中国乳腺癌患者生活方式指南》，组织编写和发布上海市抗癌协会《居民常见恶性肿瘤筛查和预防推荐》。担任上海市抗癌协会常务理事，上海市抗癌协会癌症预防与筛查专业委员会主任委员，中国抗癌协会乳腺癌专业委员会康复学组组长，中国临床肿瘤学会肿瘤大数据专家委员会常务委员，中国抗癌协会多原发和不明原因肿瘤专业委员会常务委员，中国抗癌协会乳腺癌专业委员会、科普专业委员会、肿瘤流行病学专业委员会、筛查和早诊早治专业委员会委员，中国控制吸烟协会控烟与肺癌防治专业委员会常务委员。" ]
- 基金信息：
  
  上海市加强公共卫生体系建设三年行动计划优青项目(GWVI-11.2-YQ37);上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22022308)
- DOI：10.19401/j.cnki.1007-3639.2024.04.003
  中图分类号： R737.33
- 收稿：2023-12-28，
  
  修回：2024-02-19，
  
  纸质出版：2024-04-30
- 稿件说明：
移动端阅览
沈洁, 冯小双, 温灏, 等. 572例宫颈癌远处转移患者的转移特征及生存分析：以医院为基础的真实世界研究[J]. 中国癌症杂志, 2024,34(4):361-367.

Jie SHEN, Xiaoshuang FENG, Hao WEN, et al. Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study[J]. China Oncology, 2024, 34(4): 361-367.
沈洁, 冯小双, 温灏, 等. 572例宫颈癌远处转移患者的转移特征及生存分析：以医院为基础的真实世界研究[J]. 中国癌症杂志, 2024,34(4):361-367. DOI： 10.19401/j.cnki.1007-3639.2024.04.003.

Jie SHEN, Xiaoshuang FENG, Hao WEN, et al. Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study[J]. China Oncology, 2024, 34(4): 361-367. DOI： 10.19401/j.cnki.1007-3639.2024.04.003.

摘要

背景与目的：

让宫颈癌患者获得有效的治疗是全球消除宫颈癌的策略之一。本文通过分析以医院登记为基础的宫

颈癌发生远处转移患者的转移特征及转移后生存情况，为改善宫颈癌患者的生存情况并最终消除宫颈癌提供真实世界的科学证据。

方法：

基于复旦大学附属肿瘤医院2008—2017年确诊并接受治疗的宫颈癌患者，纳入初诊时已发生远处转移或者随访过程中发生远处转移的宫颈癌患者共572例，通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存信息。研究起始时间为转移发生时间，随访统计时间截至2020年11月1日。应用Kaplan-Meier法绘制总体及不同转移部位的生存曲线，并估计不同转移部位的中位生存时间及1、3和5年总生存（overall survival，OS）率。

结果：

随访中位时间为38.93个月，期间共发生全死因死亡348例。72.55%为单一部位转移，27.45%为多发性转移。在所有转移部位中，肺转移比例最高（41.26%），其次为骨转移（15.21%），肝转移占11.54%，位列第3位。发生转移后，1、3和5年的OS率分别为62.29%（95% CI：62.25 ~ 62.33）、33.13%（95% CI：33.08 ~ 33.18）和23.42%（95% CI：23.37 ~ 23.47）。单一部位转移中，转移至肺后的1年OS率最高（72.52%），3和5年各个部位转移后的OS差异不显著。

结论：

宫颈癌最易发生远处转移的部位依次为肺、骨和肝，远处转移发生后患者的生存情况较差，规范和完善远处转移后的诊疗体系，可望改善患者的生存情况。

Abstract

Background and purpose:

Effective treatment for cervical cancer patients is one of the global strategies to eliminate cervical cancer. By analyzing the metastasis characteristics and survival status of patients with distant metastasis of cervical cancer from a hospital-based cancer registry data

our study provided real-world evidence for better survival of cervical cancer and finally eliminating cervical cancer.

Methods:

A total of 572 cervical cancer patients who had metastasis cancer at the initial diagnosis or developed distant metastasis during follow-up in Fudan University Shanghai Cancer Center from 2008 to 2017 were included in this study. Medical records review

telephone visits and death registry data linkage were applied in collecting endpoint data. The first follow-up date was the diagnose date of metastasis

and the last follow-up date was November 1

2020. Kaplan-Meier method was applied in evaluating the 1-

3- and 5-year overall survival (OS) rates for overall and site-specific patients.

Results:

The median follow-up time was 38.93 months

and 348 cases died during the follow-up. 72.55% were single site metastasis

and 27.45% were multiple metastases. Among all metastatic sites

the proportion of lung metastasis was the hi

ghest

41.26%

15.21% to bone

and 11.54% to liver. After metastasis

the 1-year

3-year and 5-year OS rates were 62.29% (95% CI: 62.25-62.33)

33.13% (95% CI: 33.08-33.18) and 23.42% (95% CI: 23.37-23.47)

respectively. In single site metastasis

1-year OS was the highest after metastasis to the lung (72.52%). Besides

there was no significant difference among different metastatic sites

both in 3-year and 5-year OS.

Conclusion:

The most frequent distant metastatic sites of cervical cancer are lung

bone and liver. The survival rate after metastasis is poor. Further research with systematic treatment strategy is required for better survival.

关键词

Keywords

references

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