The incidence and mortality of cervical cancer are high in Romania compared to other European countries, particularly for locally advanced cervical cancer cases, which are predominant at the time of diagnosis. Widely accepted therapeutic guidelines indicate that the treatment for locally advanced cervical cancer consists of concurrent chemoradiotherapy (total dose 85–90 Gy at point A), with surgery not being necessary as it does not lead to improved survival and results in significant additional morbidity. In Romania, the treatment for locally advanced cervical cancer differs, involving lower-dose chemoradiotherapy (total dose 60–65 Gy at point A), followed by surgery, which, under these circumstances, ensures better local control. In this regard, we attempted to evaluate the role and necessity of surgery in Romania, considering that in our study, residual lesions were found in 55.84% of cases on resected specimens, especially in cases with unfavorable histology (adenocarcinoma and adenosquamous carcinoma). This type of surgery was associated with significant morbidity (28.22%) in our study. The recurrence rate was 24.21% for operated-on patients compared to 62% for non-operated-on patients receiving suboptimal concurrent chemotherapy alone. In conclusion, in Romania, surgery will continue to play a predominant role until radiotherapy achieves the desired effectiveness for local control.
与其他欧洲国家相比，罗马尼亚宫颈癌的发病率和死亡率较高，其中局部晚期宫颈癌病例在诊断时占主导地位。国际公认的治疗指南指出，局部晚期宫颈癌的治疗应采用同步放化疗（A点总剂量85-90 Gy），手术并非必要手段，因其不能提高生存率且会导致显著的额外并发症。然而在罗马尼亚，局部晚期宫颈癌的治疗方案存在差异：采用较低剂量的同步放化疗（A点总剂量60-65 Gy）后进行手术，这种模式在实践中能实现更好的局部控制效果。基于此背景，我们尝试评估手术在罗马尼亚治疗体系中的作用与必要性。本研究发现，切除标本中存在残留病灶的比例达55.84%，尤其在组织学类型不良（腺癌和腺鳞癌）的病例中更为显著。此类手术在研究中伴随较高的并发症发生率（28.22%）。接受手术患者的复发率为24.21%，而仅接受次优同步化疗的非手术患者复发率高达62%。综上所述，在罗马尼亚放疗技术尚未达到理想局部控制效果前，手术治疗仍将持续发挥主导作用。
肿瘤(癌症)患者之家