435例子宫内膜癌综合治疗疗效分析

目的探讨子宫内膜癌患者综合治疗后的生存情况。方法回顾性分析1992年1月至2009年12月收治的有完整随访资料的435例子宫内膜癌患者的临床病理资料,分析不同治疗方案对患者预后的影响。结果 435例患者的中位随访时间为55.5个月,其中59例(13.6%)患者复发,58例(13.3%)患者死亡,5年总生存率为92.2%,5年无瘤生存率为88.3%。术后单纯辅助孕激素治疗≥12个月者5年无瘤生存率(95.1±2.7)%]显著高于术后无辅助治疗组(93.1±2.7)%,P<0.05];术后孕激素+放疗组患者5年总生存率(94.3±6.5)%]、5年无瘤生存率(86.1±10.8)%]均显著高于术后单纯放疗组均为(69.4±14.4)%,P<0.05)];术后单纯化疗组5年总生存率(84.2±6.3)%]、5年无瘤生存率(81.9±6.8)%]略低于术后无辅助治疗组,但两组比较,差异无统计学意义(P>0.05);术后放疗+化疗组5年总生存率(87.9±6.0)%]、5年无瘤生存率(78.3±8.7)%]与术后化疗组、放疗组和无辅助治疗组比较,差异均无统计学意义(P>0.05)。结论术后辅助孕激素治疗≥12个月、化疗、放疗+化疗可以在一定程度上改善高危子宫内膜癌患者的预后。

Clinical analysis of treatment outcome for 435 patients with endometrial cancer

Objective To investigated the post surgery treatment strategy and survival rate in patients with endometrial carcinoma. Methods 435 patients received adjuvant therapy at Peking University People＇s Hospital fol- lowing surgery with endometrial carcinoma between January 1992 and December 2009 were retrospectively reviewed and analyzed. Results Patients were followed up with the median time 65.4 months, 59 cases experienced relapse, 58 cases died. The 5-year overall survival （OS） was 92. 2%, 5-year disease free survival （DFS） was 88.3%. There was significant difference between the 5 - year disease free survival of the patient with post surgery adjuvant progestrone therapy （≥12 months） and that of the non-adjuvant therapy （P〈0.05）. Comparing the overall survival and the disease free survival of the patient with post surgery adjuvant progestrone therapy （≥12 months） plus radiation with the patients with post surgery radiation only, there were significant differences between the two groups （P〈0. 05）. The overall survival and the disease free survival of the patient with post surgery chemotherapy were lower than the patients without any sequential post surgery therapy, but no significant difference was found （P〉0. 05）. The overall survival and the disease free survival of the patient with post surgery chemotherapy plus radiation were higher than the patients with chemotherapy only or radiation only, but no significant difference was found （P〉0. 05）. Conclusion For endometrial earicinoma patients with high risk factors, post surgery treatment including adjuvant progestrone therapy （≥12 months）, chemotherapy and radiation might bring long term survial.