肿瘤细胞减灭术治疗Ⅳ期子宫内膜癌的临床价值

Clinical value of cytoreductive surgery in stage Ⅳ endometrial carcinoma

目的 :探讨Ⅳ期子宫内膜癌的治疗方法及预后影响因素。方法 :1980年 8月～ 1994年 8月 ,手术分期、术后综合治疗的Ⅳ期子宫内膜癌 4 1例 ;2 0例患者行减瘤术 ,另 2 1例未减瘤行化疗、放疗或孕激素治疗。生存曲线采用Kaplan Meier法。结果 :中位生存期 10个月。行减瘤术的患者中位生存期 17个月 ,未行减瘤术的患者中位生存期 7个月 ,两者差异有显著性(P <0 .0 0 1)。接受CAP化疗的患者生存率高 ,而非化疗组的患者相对生存率低 (P <0 .0 5 )。结论

Objective:To investigate the management of stage Ⅳ endometrial carcinoma and the factors affecting prognosis.Methods:Between 1980 and 1994,41 patients with stage Ⅳ endometrial carcinoma were treated.Twenty patients received cytoreductive surgery.Twenty one non surgery patients received chemotherapy or radiotherapy or progesterone therapy.Survival curves were made using the Kaplan Meier produce limit method.Results:The median survial was 10 months.The median survival was 17 months in patients who had undergone cytoreductive surgery,while it was 7 months in those who had not undergone surgery.The difference was significant( P <0.001).Conclusions:Hysterectomy and optimal cytoredution is feasible and necessary to improve the survival of patients with stage Ⅳ endometrial carcinoma.