术后辅助化疗对早期高危子宫内膜癌预后的影响

目的回顾性分析总结影响子宫内膜癌的预后的高危因素。方法对2000年12月至2004年12月间中山大学附属第三医院、中山大学附属第二医院及中山大学附属肿瘤医院妇科收治的Ⅰ期子宫内膜癌120例病例进行回顾性分析，其中有高危因素者共40例，术后接受辅助化疗者14例，无辅助化疗者26例，术后辅助化疗同时接受孕激素治疗者8例。术后只接受孕激素辅助治疗者23例。结果术后辅助化疗组的平均生存时间为（74．0±4．5）个月，平均复发时间是（65．0±7．0）个月，而无化疗组的平均生存时间与平均复发时问分别为（65．2±6．2）个月、（56．8±6．7）个月。两组的生存曲线、缓解曲线比较：结果P〉0．05，尚不能认为两组的生存时间有差异。多因素COX回归分析，辅助化疗、孕激素治疗及不同手术方式对生存时间、复发时间的影响，差异均无统计学意义P〉0．05。结论尚不能认为Ⅰ期高危子宫内膜癌患者术后辅助化疗能减低复发率及改善预后。

The effluence of assistant chemotherapy after operation for prognosis of early stage of endometrial carcinoma with high risks

Objective To evaluate high risks for prognosis of early stage of endometrial carcinoma.Methods Retrospective analysis was utilized to analyze the clinical materials of 120 cases of FIGO Ⅰ stage of endometrial carcinoma in the 3th Affiliated Hospital of SUN Yat-sen University,the 2 nd Affiliated Hospital of SUN Yat-sen University and the Affiliated Tumor Hospital of SUN Yat-sen University from December 2000 to December 2004.40 cases had high risks,and after operation 14 cases received assistant chemotherapy(26 cases without assistant chemotherapy),and 8cases received chemotherapy combined with progesterone therapy,and 23 cases received progesterone therapy only.Results The mean survival time and the mean recurrence time of assistant chemotherapy group were (74.0 ±4.5 ) months and ( 65.0±7.0) months respectively,and (65.2±6.2) months and (56.8±6.7) months for no assistant chemotherapy group respectively.There were no significant difference of survival time between the above two groups(P＞0.05).Through multifactor COX regression analysis,there were no significant difference of assistant chemotherapy,progesterone therapy or operation style in influencing the survival time and recurrence time.Conclusion The conclusion could not he obtained that assistant chemotherapy after operation could lower recurrence rate and improve prognosis of early stage of endometrial carcinoma with high risks.