年轻子宫内膜癌患者保留生育、生理功能治疗的现状及进展

Status and progress of retaining the fertility treatment, physiological function in young patients with endometrial cancer

年轻子宫内膜癌患者的预后好，5年总生存率可达100％，但有40％以上的患者伴有不孕，因此保留年轻子宫内膜癌患者的生育、生理功能非常必要。保留生育功能最常用的保守治疗方法是孕激素治疗，其有效率为42％~89％，疗后妊娠成功率可达40％~50％，在ART辅助下妊娠率可提高到80％以上。然而，接受保守治疗的年轻子宫内膜癌患者有40％的复发率，且有4％～25％的患者可能同时伴有卵巢癌。因此，患者完成生育后建议行全子宫、双侧附件切除及盆腔淋巴结清扫术。

Young patients with endometrium cancer have good prognosis and the five-year overall survival rate can reach 100%. But there is more than 40% of the patients are together with infertility, so it is very necessary to preserve the fertility and physiological function of young endometrial cancer patients. The most common conservative treatment to preserve fertility is the progestin therapy and the effective rate is 42%-89%, and while the successful pregnant rate could achieve to 40%-50% after the conservative treatment, What＇s more, the pregnant rate could be improved to 80% above by ART assisting. However, the recurrence rate of young endometrial cancer patients who accepted conservative treatment is 40%, and that 4%-25% of the patients may have ovarian cancer at the same time. Consequently, the total hysterectomy, BSO and lymphadenectomy is suggested after the patients accomplish fertility.