不同手术方式对Ⅰ期子宫内膜癌患者术后生存及复发的影响

目的 探讨不同手术方式对Ⅰ期子宫内膜癌患者术后生存及复发的影响。 方法 回顾性分析了Ⅰ期子宫内膜癌67例。根据手术方式不同，将其分为两组，A组36例：广泛子宫切除加盆腔淋巴结清扫术，B组31例：全宫加双附件切除术。分析两组5年生存率及复发情况。 结果 两组患者术后复发率分别为18.2％、16.7％，5年生存率分别为87.9％、90.0％。两组比较，差异无显著性（P>0.05）。随访发现共有11例复发，其中有7例发生远处转移，占63.6%。在术后有无化疗两种情况下，复发患者远处转移分别占40％、83.3％，存在显著性差异（P<0.05）。 结论 Ⅰ期子宫内膜癌患者可以采用全子宫加双附件切除术，扩大手术范围及行淋巴清扫术并不能提高生存率。远处转移在术后复发中占相当比例，术后辅助化疗对抑制盆腔外复发有一定帮助。

Influence of different surgical procedures on survival and recurrence of stage I endometrial carcinoma

Objective To determine the influence of different surgical procedures on the postoperative survival rate and recurrence of stage I endometrial carcinoma. Methods A retrospective study of 67 patients with stage I endometrial carcinoma were investigated after they finished their surgical treatment. The patients were divided into two groups (groupA: 36 cases of radical hysterectomy and pelvic lymphadenectomy; groupB: 31 cases of total hysterectomy and bilateral salpingo-oophorectomy). Survival and recurrent rates were analyzed according to the data of follow-up visit. Results The recurrent rates of the two groups are 18.2％ and 16.7％ respectively, five year survival rates are 87.9％ and 90.0％. There is no significant difference between them (P>0.05). Eleven relapse cases were observed within follow-up visit. Seven cases had distant metastasis with average incidence rate of 63.6% among them. The distant metastasis rates are 40% and 83.3% respectively among the relapse cases with chemotherapy or not. There is significant difference between them (P<0.05). Conclusions The patients with stage I endometrial carcinoma can be treated by total hysterectomy and bilateral salpingo-oophorectomy. Radical operation and pelvic lymphadenectomy do not increase the survival rate. The distant metastasis rate is remarkable among relapse cases. The adjuvant chemotherapy can help to inhibit the recurrenc outside pelvic cavity.