59例Ⅰ期子宫内膜癌的治疗分析

Different Treatment and Their Prognosis of 59 Endometrial Carcinoma Stage I

目的为探讨Ⅰ期子宫内膜癌更为合理的治疗方案。方法将５９例Ⅰ期子宫内膜癌患者随机分为两组：第１组３０例，单纯全子宫、双附件切除加辅助治疗〔化、放疗和（或）激素治疗〕；第２组２９例，行全子宫、双附件切除加盆腔淋巴结清扫或活检。结果第１组中死亡２例，２年和５年的存活率均为９６６％，平均生存６９７个月。第２组中死亡３例。２年存活率为９５７％，５年存活率为８５２％，平均生存４３９个月。这３例患者术后均未接受任何辅助治疗，发生远处器官或淋巴结转移后死亡。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，Ⅰ期子宫内膜癌患者存在远处转移可能。是否所有Ⅰ期患者均应接受放射治疗，放射治疗对远处转移灶的效果，以及其它辅助性治疗如化疗药物的新配伍、新剂量和新方案等均有待于进一步探讨。

Objective\ Investigating the treatment for endometrial carcinoma stage I.Methods\ 59 women who had endometrial carcinoma stage I were divided into 2 groups randomly.30 patients were in group 1,who accepted the adjuvant therapy including chemo-,radio-and hormonotherapy after hysterectomy and bilateral salpingo-oophorectomy.The other 29 underwent the systematic retroperitoneal lymphadenectomy or retroperitoneal lymph nodes samplings.Results\ The 2-year and 5-year survival rate were both 96 6% in group 1 and 95 7% and 85 2% in group 2.There was no significant difference( P >0 05).4 of 5 dead patients were died of distant metastasis.Conclusions\ Retroperitoneal lymphadenectomy or retroperitoneal nodes biopsy play a more important role in diagnosis than in therapy in endometrial carcinoma stage I.The advanced discussion is to find the more effective therapy for distant metastasis.