Abstract:Objective: To analyze the effect of the clinicopathological features and different surgical approaches on the prognosis of cervical cancer and the choice of appropriate postoperative treatment. Methods: A total of 217 patients with FIGO 2018 stageⅠA2-ⅡA1 cervical cancer, excluding stageⅠB3, admitted to our hospital from January 2013 to September 2018 were selected in this study. There were two surgical approaches: laparotomy and laparoscopy. The risk factors were assessed after surgery. The patients were divided into radiotherapy group, chemotherapy group and chemoradiotherapy group for postoperative adjuvant therapy. The efficacy and adverse reactions are evaluated. Results: Of the 217 patients, 122 underwent laparoscopic surgery and 95 underwent laparotomy, and there was no significant difference in the prognosis between the two surgical approaches. Postoperative pathology showed that only deep stromal invasion accounted for 48.85%, only lymphovascular space invasion accounted for 9.22%, two intermediate risk factors accounted for 28.57%, and three intermediate risk factors accounted for 4.61%.Lymphovascular space invasion had an adverse effect on progression-free survival time and overall survival of patients, and was an independent prognostic factor for stageⅠA2-ⅡA1 cervical cancer, which was significantly different from the group without lymphovascular space invasion. There was no significant difference in progression-free survival time and overall survival among the groups in the radiotherapy, chemotherapy, and chemoradiotherapy groups. The main adverse reaction of treatment was myelosuppression, and gradeⅢ/Ⅳmyelosuppression had the highest incidence in the chemoradiotherapy group. The above adverse reactions were relieved after symptomatic treatment, without treatment-related death. Conclusion: Radiotherapy is recommended as a postoperative adjuvant treatment for stageⅠA2-ⅡA1 cervical cancer.
