分期手术治疗子宫内膜癌214例.doc

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1、分期手术治疗子宫内膜癌214例作者：作者：吴玉梅徐晓红张铁娟邓小虹【关键词】子宫内膜癌Stagingoperationintreatmentof214patientswithendometrialcarcinoma[Abstract】AIM:Toevaluatethestagingoperationinthetreatmentofendometrialcarcinoma.METHODS:From1990to2002,214patientswithendometrialcarcinomaincli

2、nicalstageIweretreatedwithstagingoperation(SOgroup,n二134)andtotalhysterectomyplusbilateralsalpingoophorectomy(HBSOgroup,n=80)respectivelyinourhospita1.Theirclinicopathologicaldatawereanalyzedretrospectively.RESULTS:①The5yearsurvivalratewas86.1%inHBSO

3、groupand84.7%inSOgroup・Nosignificantdifferencewasfoundbetweenthetwogroups(P>0.05).ComparedwiththeSOgroup,HBSOgroupwasofsignificantlylesscomplications(P&It;0.05).②Amongthe12recurrencecases,therewere7casesofdistantmetastasisand5casesoflocalrecurrence・T

4、herecurrenceandmetastasiswererelatedwiththeoperationtype・ThelocalrecurrencerateinHBSOgroupwassignificantlyhigherthanthatofSOgroup(P&It;0・01)・③The5yearsurvivalrateofthecaseswithlymphnodemetastasiswassignificantlylower(42.3%)thanthatofoneswithoutmetast

5、asis(75.5%)(P&It;0.01).Thelymphnodemetastasisratewasrelatedtocervicalinvolvement,myometrialinvasion>1/2,specialpathologictypeandhistologicallowdifferentiation(G3)significantly.CONCLUSION:LymphadenectomyforclinicalstageIendometrialcarcinomaresultsinmo

6、reoperationcomplications,butcan?tincreasesurvivalratesignificaritly.LymphadenectomyissuitableforclinicalstageIcaseswithhighriskfactors・Radiotherapyandchemotherapyarenecessaryforcaseswith1ymphnodemetastasis・[Keywords】endometrialneoplasms:operation;tre

7、atmentoutcome;prognosis【摘要】目的：探讨分期手术治疗子宫内膜癌的临床价值.方法：回顾性分析1990/2002分期手术(S0组,n=134)和全子宫加双附件切除术(HBSO组,n=80)治疗的214例临床I期子宫内膜癌的临床病理资料.结果：①临床I期的HBSO组与S0组5a生存率分别为86.1%及84.7%,两组无显著性差异(P>0.05).两种术式比较，HBS0组明显比S0组的手术并发症少(P<O.05).②12例复发病例中7例远处转移，5例为盆腔复发.转移、复发与

8、术式有关，其中HBSO组局部复发率极明显高于S0组(P<0.01).③淋巴结转移者的5a生存率42.3%,极明显低于无转移者的75.5%(P<0.01)•淋巴结转移率与宫颈受侵、肌侵>1/2、特殊病理类型、组织低分化(G3)显著相关.结论：临床I期子宫内膜癌常规行淋巴清扫术，并发症增加，不能显著提高生存率.淋巴结清扫术对具有高危因素者是必要的.对淋巴结转移者宜术后行放疗和化疗.【关键词】子宫内膜癌；手术；治疗结果；预后0引言子宫内膜癌的手术病理分期中规定腹腔细胞学检查、盆腔及腹主动脉