Ⅰ期子宫内膜癌128例治疗及预后临床分析

目的了解不同手术方式对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Ⅰ期子宫内膜癌128例.根据手术方式不同,将其分为两组,A组;次广泛(或全子宫)+双附件切除术,80例;B组A组术式+盆腔淋巴结清扫术,48例,分析二组生存率及复发情况.结果 A、B两组的5年生存率分别为95.24%,94.87%,两组比较,差异无显著性(P>0.05),随访中,12例复发,复发率11.76%,10例在3年内复发,其中盆腔复发3例,肺转移6例,A、B两组复发率分别为7.94%,17.95%,分别比较,差异均无显著性(P>0.05).结论腹膜后淋巴结切除可明确分期,但不是Ⅰ期子宫内膜癌的治疗手段,扩大手术范围并不能显著提高患者的生存率,远处转移在术后复发中占相当比例,有高危因素时,应考虑辅助治疗.

Clinical analysis of different surgical treatments of stage I endometrial carcinoma:a prognosis report of 128 clinical cases

Objective To determine the influence of different surgical procedures on the post-operative survival rate and recurrence of stage I endometrial carcinoma. Methods A retrospective study of 128 patients with stage I endometrial carcinoma were investigated after they finished their surgical treatments in Ningbo city No.1 hospital. The patients were divided into two groups (group A:80 cases of modified radical hysterectomy or total hysterectomy with bilateral salpingo-oophorectomy;group B:48 cases of modified radical hysterectomy or total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy). Survival and recurrent rates were analyzed according to the data of follow-up visit. Results Five-years survival rate of the two groups are 95 24% and 94 87%, respectively ( P >0 05). Twelve relapse cases were observed with average of recurrent rates of 11 76%. Among them ten? cases relapsed within three years after their operations and three had local recurrence and six? lung metastasis. Recurrent rates of two groups are 7 94%, and 17 95%, respectively ( P> 0 05) with no statistical significance. Conclusions Retroperitoneal lymphadenectomy or retroperitoneal lymph nodes biopsy plays a more important role in diagnosis of endometrial carcinoma at stage I, but not an effective way for treatment. Radical operation does not increase the survival rate, and distant metastasis is remarkable after radical surgery. Adjuvant therapy should be considered for such cases.