Ⅰ 期子宫内膜癌128例临床分析

Clinical Investigation on 128 Cases of Stage Ⅰ Endometrial Carcinoma

目的 :了解不同手术方式对 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 期子宫内膜癌 1 2 8例。根据手术方式不同 ,将其分为两组 ,A组 80例 ,次广泛 (或全子宫 ) +双附件切除术。 B组 48例 ,A组术式 +盆腔淋巴结清扫术。分析两组生存率及复发情况。结果 :A、B两组 5年生存率分别为 95 .2 3%、94.87% ( P>0 .0 5 )。随访中 1 2例复发 ,复发率 1 1 .76%。3年内复发 1 0例 ,其中盆腔复发 3例 ,肺转移 6例。两组复发率 ,A组 7.93% ,B组 1 7.94% ( P>0 .0 5 )。结论 :腹膜后淋巴结切除可明确分期 ,但不是 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。

Objective: To determine the effect of different surgical procedure on post operative survival rate and recurrence of stage Ⅰ endometrial carcinoma.Methods:128 cases of stage Ⅰ endometrial carcinoma were studied retrospectively. They were divided into two groups according their different surgical methods: 80 cases in A group with modified radical hysterectomy or total hysterectomy plus bilateral salpongo oophprectomy, 48 cases in B group with group+pelvic lymphadenectomy. The survival and recurrent rates were analyzed according to their follow up data. Results: Five years rates in two groups were 95.23% and 94.87% respectively( P >0.05).When followed up, 12 cases relapsed. The recurrent rates were 11.76%, 10 cases relapsing within 3 years after operation ,3 with local recurrence and 6 with lung metastasis. Recurrent rates in two groups were 7.93% in A group and 17.94% in B group respectively( P >0.05). Conclusion:Retroperitoneal lymphadene coty or retropetritoneal nodes biopsy play a more important role in diagnosis than in therapy in endometrial carcinoma stage Ⅰ. Radical operation will not increase the survival rate. Distant metastasis is remarkable in recurrence after operation, which should be considered in the adjuvant therapy with high dangerous factors existing.