摘要
目的:评价子宫内膜癌单纯腹腔液细胞学阳性患者术后辅助治疗的意义。方法:回顾性分析37例单纯腹腔液细胞学阳性而无宫外转移的ⅢA期患者术后辅助治疗情况。结果:37例单纯腹腔液细胞学阳性患者分为3组;1)高危组包括14例深肌层浸润及4例浆液性乳头状腺癌患者;2)低危组术后辅助治疗患者9例;3)低危组术后未接受辅助治疗患者10例。术后辅助治疗包括单纯放疗、单纯化疗、放疗联合化疗。本组共有5例复发,总复发率13.5%(5/37)。术后辅助治疗者4例复发,复发率14.8%(4/27),其中2例为浆乳癌患者;术后无辅助治疗者1例复发,复发率10.0%(1/10)。寿命表法计算5年生存概率,37例患者总的5年生存率为71.5%。术后无辅助治疗者73.0%,术后给予辅助治疗者68.1%,二者无显著性差异(P>0.05)。高危组术后辅助治疗的患者5年生存率为63.4%,低危组术后辅助治疗的患者5年生存率为74.3%。具有高危因素的患者与不具有高危因素的患者相比,无论术后是否进行辅助治疗其5年生存率低,有显著性差异(P<0.05)。术后单纯放疗者5年生存率66.7%,术后单纯化疗者63.7%,二者无显著性差异(P>0.05);术后放疗联合化疗者75.0%,与单纯放疗或单纯化疗者比较,有显著性差异(P<0.05)。结论:子宫内膜癌单纯腹腔液细胞学阳性对预后的影响不显著,具有高危因素的患者即使术后辅助治疗其预后也较差,不具高危因素的患者术后是否进行辅助治疗对生存率无明显影响。
Objective： To determine the value of postoperative adjuvant therapy for endometrial carcinoma in patients with positive peritoneal washing cytology. Methods： Thirty-seven patients with stage Ⅲ A endometrial carcinoma who had positive peritoneal cytology were analyzed retrospectively. Results： The patients were divided into 3 groups as follows： 18 patients were in the high-risk group that included 14 patients with deep myometrial invasion and 4 patients with papillary serous carcinoma, 9 patients were in a low-risk group and received adjuvant therapy after surgery, and 10 patients were in a second low-risk group and received no treatment after surgery. Adjuvant therapy after surgery consisted of radiotherapy alone, chemotherapy alone or radiotherapy combined with chemotherapy. Recurrence oeeurred in 5 of 37 patients （13.5%）. Four of 27 patients （15.8%） who received adjuvant therapy and 1 of 10 patients （10%） with low-risk disease who received no adjuvant treatment had recurrence. The overall accumulated 5-year survival rate of the 37 patients was 71.5%. The accumulated 5-year survival rate in patients who received or did not receive adjuvant therapy was 68.1% and 73%, respectively. The 5-year survival rates of patients with low-risk disease who did and did not receive adjuvant therapy post-operatively were 74.3% and 73%, respectively. The 5-year survival rate of patients with high-risk disease was 63.4%, which was lower than the 5-year survival rate of patients with low-risk disease regardless of whether or not they received postoperative adjuvant therapy. The 5-year survival rate of patients who received radiation alone or chemotherapy alone was 66.7% and 63.7%, respectively. The 5-year survival rate of patients who received radiotherapy combined with chemotherapy was 75%, significantly higher than that found with radiation or chemotherapy alone. Conclusion： Postoperative adjuvant treatment for patients with low- to moderate-risk stage ⅢA endometrial carcinoma with positive peritoneal cy
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第14期822-825,共4页
Chinese Journal of Clinical Oncology
关键词
子宫内膜肿瘤
细胞学
辅助治疗
预后
Endometrial neoplasms Peritoneal cytology Prognosis Adjuvant therapy
