子宫内膜癌手术方式的选择与预后

目的 探讨各种手术方式对子宫内膜癌患者预后的影响。方法 收集我院1970～1998年收治的子宫内膜癌患者238例,将所有病例按手术病理分期、病理类型和组织学分级分为低危、中危和高危三组,比较各种手术方式对各组患者预后的影响。结果 低、中危组主要行全子宫加双附件切除术或次广泛子宫切除术,各种术式生存率无显著差异(P>0.05)。高危组Ⅰa+Ⅰb期、Ⅰc期、Ⅱ期行次广泛(或广泛性)子宫切除附加盆腔淋巴结清扫术与单纯行次广泛子宫切除术相比,生存率差异无显著性(P>O.05)。Ⅲ、Ⅳ期主要行次广泛子宫切除术或广泛性子宫切除附加盆腔淋巴结清扫术,这两种术式的生存率差异无显著性(P>0.05)。结论Ⅰa+Ⅰb期腺癌可以单纯行全子宫加双附件切除术或次广泛子宫切除术。Ⅰa+Ⅰb期除腺癌外其他病理类型以及Ⅰc、Ⅱ期可以行广泛性子宫切除术附加盆腔淋巴结清扫术。Ⅲ、Ⅳ期患者预后差,手术方式对预后影响不大。

The choke of surgical methods in endometrial carcinoma related with prognosis

Objective To compare the different surgical methods with the prognosis of endometrial carcinoma. Methods According to surgical- pathological staging, pathological types and histological grades, 238 cases with endometrial carcinoma from 1970 to 1998 admitted in our hospital were divided into three groups: high risk, moderate risk and low risk. Results The moderate and low risk groups were not significantly different in cumulative survival rates related with different surgical methods (P > 0.05) . Conchsions Total abdominal hysterectomy with bilateral salpingo - oophorectomy and partial radical hysterectomy were qualified for adenocarcinoma of I a + I b stages. Radical hysterectomy with pelvic lymphadenectomies was better than other surgical methods for I a -I- I b, of the high risk group also I c and II stages. The prognosis of III and IV stages was poor and various surgical methods gave no significant difference in prognosis.