|本期目录/Table of Contents|

Ⅰ-Ⅱ期子宫内膜癌术后辅助治疗疗效评价及预后因素分析

《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:
2022年13期
页码:
2404-2410
栏目:
论著（妇科肿瘤）
出版日期:
2022-05-30

文章信息/Info

Title:
Evaluation of adjuvant therapy for stage Ⅰ-Ⅱ endometrial cancer and analysis of prognostic factors
作者:
迪丽努尔·吐松; 祖菲娅·艾力
新疆医科大学第一附属医院妇科，新疆 乌鲁木齐 830000
Author(s):
Dilinuer?Tusong; Zufeiya?Aili
Department of Gynecology,the First Affiliated Hospital of Xinjiang Medical Universit,Xinjiang Urumqi 830000,Ghina.
关键词:
子宫内膜癌; 预后; 放化疗; 辅助治疗
Keywords:
endometrial cancer; prognosis; radiotherapy and chemotherapy; adjuvant therapy
分类号:
R737.33
DOI:
10.3969/j.issn.1672-4992.2022.13.022
文献标识码:
A
摘要:
目的:探讨Ⅰ-Ⅱ期子宫内膜癌术后不同辅助治疗方式对患者生存和预后的价值，并综合分析其中影响预后因素。方法：对符合纳入标准并在我院妇科中心治疗的Ⅰ-Ⅱ期子宫内膜癌患者随访资料、病理结果以及临床数据进行回顾性分析，对影响患者术后生存结局和预后因素分别进行Kaplan-Meier生存分析和多因素Logistic回归模型分析；卡方检验分析复发率及生存率。有统计学差异用P＜0.05表示。结果：本研究共纳入143例患者，其中术后化疗者58例、放疗者19例、联合放化疗者66例，中位随访时间59个月，生存时间为24~144个月,3年及5年生存率化疗组为92.90%、82.40%，放疗组为93.10%、87.50%，联合放化疗组为98.10%、88.30%，三组数据差异有统计学意义(χ2=6.029,P=0.04)。未复发率化疗组为36%，放疗组为14%，放化疗组为50%，差异有统计学意义(χ2=9.385,P=0.01)。χ2检验结果表明：患者年龄、是否复发、组织学分级及类型与术后辅助治疗疗效差异有统计学意义(P＜0.05)。术后放化疗可能是保护性因素［P＜0.05,OR=0.563,95%CI(0.048~6.563)］；而术后复发是一项强有力的独立危险因素［P＜0.01,OR=42.047,95%CI(21.708~61.121)］。结论：组织学类型、分级，术后辅助治疗方式，复发情况可影响Ⅰ-Ⅱ期子宫内膜癌患者的生存情况，术后联合放化疗能够有效避免疾病再发，改善生存率以及总生存时间。
Abstract:
Objective:To study the remaining alive patients and predictive factors of different methods of adjuvant treatment for patients with stage Ⅰ-Ⅱ endometrial cancer after surgery,and comprehensively evaluate the elements that influence the prognosis.Methods:A retrospective analysis of the follow-up material,pathological results,and clinical data of patients with stage Ⅰ-Ⅱ endometrial cancer who met the inclusion criteria and were treated in the gynecology center of our hospital,to influence the survival outcome and prognosis of the patients.Kaplan-Meier survival analysis and multivariateregression model were used to analyze the factors.The recurrence rate and survival rate were analyzed by chi-square test.Affecting elements of prognosis were evaluated by the multivariate Logistic regression model.P＜0.05 means the difference is statistically significant.Results:Among the 143 patients with stage Ⅰ-Ⅱ endometrial cancer,there were 58 cases of postoperative chemotherapy,19 cases of radiotherapy,and 66 cases of combined radiotherapy and chemotherapy.The median follow-up time was 59 months,and the remaining alive time was 24~144 months.The 3-year and 5-year survival rates of chemotherapy group,radiotherapy group,and combined radiotherapy and chemotherapy group were 92.90% and 82.40%,93.10%,and 87.50%,98.10% and 88.30%,respectively,(χ2=6.029,P=0.04).The non-recurrence rate was 36% in the chemotherapy group,14% in the radiotherapy group,and 50% in the combined radiotherapy and chemotherapy group.The difference was statistically significant(χ2=9.385,P=0.01).The results of the χ2 the test showed that:the patient's age,recurrence,histological grade and type,and postoperative adjuvant treatment efficacy were significantly different(P＜0.05).In postoperative adjuvant therapy,chemoradiotherapy may be a protective factor［P＜0.05,OR=0.563,95%CI(0.048~6.563)］,while postoperative recurrence is a strong independent risk factor［P＜0.01,OR=42.047,95%CI(21.708~61.121)］.Conclusion:Thehistological type,grading,postoperative adjuvant therapy,and recurrence can affect the survival of patients with stage Ⅰ-Ⅱ endometrial cancer.Postoperative radiotherapy combined with chemotherapy can effectively avoid disease recurrence,improve survival rate and overall survival time.

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备注/Memo

备注/Memo:
省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目（编号：SKL-HIDCA-2018-20）；新疆医科大学研究生创新创业项目（编号：CXCY2021016）
更新日期/Last Update: 2022-05-31