子宫内膜癌的治疗及预后──418例回顾性研究

 本文对自1958～1981年底中国医学科学院肿瘤医院治疗的418例宫内膜患者进行回顾性研究。其中Ⅰ期228例,Ⅱ期105例、Ⅲ期76例,Ⅳ期9例,复发共75例。在Ⅰ、Ⅱ期患者,影响预后的因素有:(1)宫颈管受累,(2)肌层侵犯,(3)治疗方式。手术或手术与放射综合治疗是最宜的治疗方式。Ⅱ期颈管受累的假阳性率较高(56.1％),因而靠分段诊刮取材而做出诊断的弊端有待解决。对Ⅲ、Ⅳ期患者如有可能也应尽量切除原发病灶,不能手术者放射治疗是主要治疗手段,并应辅以激素或化疗。复发患者虽预后不佳但不应轻易放弃治疗。作者在总结我院418例患者治疗和预后的基础上结合已开展的雌、孕激素受体测定,重新整理和制定了包括手术、放射、激素和化疗在内的宫内膜癌的综合治疗方案。

THE PROGNOSIS AND TREATMENT OF ENDOMETRIAL CANCER

Four hundred and eighteen patients with endometrial cancer who were treated in Cancer Institute (Hospital), CAMS from 1958 to 1981 were studied retrospec-tively. 228 patients had stage Ⅰ, 105 patients had stage Ⅱ, 76 patients had stage Ⅲ,9 patients had stage Ⅵ, 75 patients had recurrent disease. In stage Ⅰ and Ⅱ,variables found to have a statistically significant influence on survival were 1).endoncervical involvement. 2). myometrical infiltration. and 3). trcatmentmodalities. Surgery and combination of surgery and radiotherapy are the optimaltreatment modolities. In stage Ⅱ false rate is 56.1%, the clinical staging mainlybased on the first fractional curettage specimen should be discussed. In stage Ⅲand Ⅵ if possible, surgical eradieation of macroscopic tumor should be performed;if inoperable, radiotherapy is the optimal method of treatment. Radiotherapyin combination with hormone therapy or chemotherapy should be stressed. Forrecurrent disease, even the treatment possibilities are limited reatment should not be abandoned. A combined treatment planning for patients with endometrialcarcinoma has also been suggested.