期刊
GYNECOLOGIC ONCOLOGY
卷 156, 期 3, 页码 676-681出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2019.12.022
关键词
Cervical carcinoma; Tumor-stroma ratio; FIGO stage IIIC; Survival; Prognosis
资金
- National Natural Science Foundation of China [81572559, 81772783, 81971475]
- National Key Research and Development Program of China [2016YFC1302900]
- Key Research Project of Shandong Province [2017CXGC1210]
- Chinese Academy of Medical Sciences Initiative for Innovative Medicine [CAMS-2017-I2M-1-002, CAMS-2016-12M-1-001]
Objective. To determine the value of the tumor-stroma ratio (TSR) while identifying prognostic factors in patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IIIC squamous cell carcinoma of the cervix following primary radical surgery. Methods. Three hundred eighty-four patients with node-positive squamous cell carcinoma of the cervix (2018 FIGO stage IIIC) who underwent radical surgery between January 2005 and December 2016 were included in this retrospective study. The TSR5 were assessed on hematoxylin and eosin-stained tumor slides and classified as stroma-low (<50% stroma) or stroma-high (>= 50% stroma). Results. Sixty-seven patients were categorized as stroma-high; they had shorter disease-free survival (DFS) and overall survival (OS) periods than did their stroma-low counterparts. On multivariate analysis, a tumor size >= 4cm, >= 3 metastatic lymph nodes, and stroma-high status were independent predictors of shorter DFS and OS. These factors were incorporated into a prognostic scoring system in which patients were categorized into low-(score 0), intermediate-(score 1), and high-risk (scores 2-3) groups. The scoring system differentiated DFS and OS well (C-index = 0.65, 95% confidence interval, 0.59-0.72; and C-index = 0.65, 95% confidence interval, 0.59-0.72, respectively). Conclusions. The TSR is an independent prognostic factor, and our prognostic scoring system that incorporates this parameter exhibits good discriminative ability for both recurrence and survival in patients with 2018 FIGO stage IIIC cervical cancer after radical surgery. The TSR is a potentially novel clinicopathological variable for predicting the prognoses of these patients contingent on the validation of our findings. (C) 2019 Published by Elsevier Inc.
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