Analysis of Pretreatment Prognostic Factors in Locally Advanced Carcinoma of the Uterine Cervix

국소진행된 자궁경부암에 있어서의 예후인자 분석

To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1986. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was $58\%$, $51\%$, and $27\%$ in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was $57\%$, $40\%$, and $25\%$ for each stage respectively. Five year overall survival was $67\%$, $51\%$, and $33\%$ in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than $10\;g\%$, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography (IVP), pelvic lymph node (LN) status on CT, and pelvic sidewall invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. in terms of overall survival, the size.

국소진행된 자궁경부암에 있어서의 예후인자를 알아보기 위하여 1979년 3월부터 1986년 12월까지 서울대학교병원에서 근치적방사선치료를 시행받은 154명의 환자를 대상으로 후향적 분석을 시행하였다. FIGO 병기 IIIA, IIIB, IVA의 환자 수는 각각 8, 134, 12명 이었고 병기에 따른 5년 국소치료율은 각각 $58\%$, $51\%$, $27\%$이었으며 5년 무병생존율은 각각 $57\%$, $40\%$, $25\%$, 5년 생존율은 각각 $67\%$, $51\%$, $33\%$이었다. 단변수분석에 의하면 임신 횟수, 혈색소치, 전산화단층촬영상 골반측벽 침범소견이 국소치료율에 영향을 미치는 인자 이었고 임신 횟수, 혈색소치, 전산화단층촬영상의 골반측벽 침범소견과 함께 요로조영술상의 요로패쇄증, 전산화단층촬영상의 골반임파절 비대가 무병생존율에 영향을 미치는 인자 이었으며 생존율에 영향을 미치는 인자는 전산화단층촬영상의 골반측벽 침범소견 및 방광침범소견 이었다. 다변량분석에 의하면 국소치료율에 영향을 미치는 인자는 없었고 무병생존율에 영향을 미치는 인자는 전산화단층촬영상의 골반임파절 비대이었으며 생존율에 영향을 미치는 인자는 원발병소의 크기였다.