Purpose: About one-third of the world's total annual new cervical cancer cases are found in the People's Republic of China. We investigate the prevalence and clinical characteristics of cervical cancer cases in the People's Republic of China over the past decade.
Method: A total of 10,012 hospitalized patients with cervical cancer from regions nationwide were enrolled from 2000 to 2009. Demographic and clinical characteristics, therapeutic strategies, and outcomes were analyzed.
Results: The mean age at diagnosis of all cervical cancer patients was 44.7 ± 9.5 years, which is 5-10 years younger than mean ages reported before 2000 in the People's Republic of China. The age distribution showed 16.0% of patients were ≤35 years old, 41.7% were 35-45 years old, and 41.7% were >45 years old. Early stage diagnoses were most prevalent: 57.3% were stage I, 33.9% were stage II, and 4.3% were stage III or IV. Most patients (83.9%) were treated with surgery, and only 9.5% had radiotherapy alone. Among 8,405 patients treated with surgery, 68.6% received adjuvant treatments, including chemotherapy (20.9%), radiotherapy (26.0%), and chemoradiotherapy (21.9%). Among stage IA patients, 16.0% were treated with corpus uteri preservation. The proportion of ovarian preservation was 42.0%.
Conclusions: Cervical cancer cases in the People's Republic of China show increasing prevalence in young patients and at early stages. In the past 10 years, surgery has become the dominant treatment and is increasingly combined with adjuvant chemotherapy for patients with stages I and II. Conservative surgical approaches are reasonable options for genital organ preservation in selected patients.
摘要
目的 在全世界每年新增的宫颈癌病例中，约有三分之一是来自中国。我们探讨了中国过去十年中的宫颈癌患病情况和临床特征。
方法 从 2000 年到 2009 年，我们从全国各地共招募了10 012名宫颈癌住院患者。我们分析了他们的人口学特征、临床特征、治疗策略以及治疗结局。
结果 所有宫颈癌患者的总体平均确诊年龄为 44.7±9.5 岁，比中国在 2000 年之前报告的平均确诊年龄低 5~10 岁。患者的总体年龄分布为：16.0%的患者 ≤35岁，41.7% 的患者在 35 到 45 岁之间，41.7% 的患者 > 45岁。在所有确诊病例中，早期宫颈癌所占比例最高：I期占 57.3%，II 期占 33.9%，III 或 IV 期占 4.3%。大多数患者(83.9%) 接受了手术治疗，仅有 9.5%接受了单纯放疗。在 8 405例接受手术治疗的患者中，有 68.6%接受了辅助治疗，其中包括化疗 (20.9%)、放疗(26.0%) 和放化疗 (21.9%)。在 IA 期患者中，有 16.0%保留了子宫体。保留卵巢的患者占 42.0%。
结论 中国的宫颈癌病例呈低龄化趋势，且早期病例的比例逐渐升高。在过去10 年中，手术治疗已成为 I 期和 II期患者的主导疗法，而且越来越多地与辅助化疗联合进行。对于想要保留生殖器官的特定患者而言，保守性手术治疗是一个合理的选择。
Keywords: Cervical cancer; Clinical feature; Surgery; Survival rate; Therapeutic strategies.