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[目的]探讨外阴鳞癌ⅠB期不同治疗方式的复发情况。[方法]对30例确诊并治疗的外阴鳞癌ⅠB期进行回顾性分析,用Kaplan-Meier方法进行预后比较。[结果]外阴鳞癌ⅠB期1年复发率为26.67%(8/30)。对于仅行手术治疗者,外阴局部扩大切除术患者复发率为60%(3/5),而外阴广泛切除术+腹股沟淋巴结清扫者为23.0%(3/13),差异具有统计学意义(P=0.045)。对于行外阴广泛切除术+腹股沟淋巴结清扫术者23例,有复发高危因素如病理分化差、瘤体大等共14例,行外阴广泛切除术+腹股沟淋巴结清扫术+放疗和(或)化疗者1年复发率为10%(1/10),而行外阴广泛切除术+腹股沟淋巴结清扫术者为50%(2/4),1年复发率差异具有统计学意义(P=0.03)。[结论]对于ⅠB期外阴鳞癌,尽可能行腹股沟淋巴结清扫,对于有高危因素者,手术结合放疗或(和)化疗能降低其近期复发率。
[Objective] To investigate the recurrence of different treatment of vulvar squamous cell carcinoma in stage ⅠB. [Methods] A total of 30 patients with confirmed and treated vulvar squamous cell carcinoma (IB) were retrospectively analyzed. The prognosis was compared by Kaplan-Meier method. [Results] The recurrence rate of ⅠB in vulvar squamous cell carcinoma was 26.67% (8/30). For patients who underwent surgical excision of the vulva, the recurrence rate was 60% (3/5) in patients with vulvar partial enlargement, and 23.0% (3/13) in vulvar excision + dissection of the inguinal lymph nodes (P <0.05). The difference was statistically significant (P = 0.045). For line vulvar extensive excision + inguinal lymph node dissection in 23 cases, there are high risk factors for recurrence such as poor pathological differentiation, the tumor a total of 14 cases, line vulvar extensive excision + inguinal lymph node dissection + radiotherapy and / or chemotherapy The recurrence rate was 10% (1/10) in one year and 50% (2/4) in extensive vulvar resection plus inguinal lymphadenectomy. The difference in recurrence rate at one year was statistically significant (P = 0.03). [Conclusion] For IB period vulvar and squamous cell carcinoma, the groin lymph node dissection is performed as far as possible. For patients with high risk, operation combined with radiotherapy or (and) chemotherapy can reduce the recent recurrence rate.