术前子宫内膜活检为高分化肿瘤的子宫内膜癌患者的手术分期、最终分级和存活情况

作     者：EltabbakhG.H. Shamonki J. Mount S.L. 马超 

作者机构：Lake Champlain Gynecologic Oncology 364 Dorset Street South Burlington VT 05403 United States 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第2期

页      面：43-44页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：手术分期 子宫内膜活检 高分化肿瘤 存活情况 盆腔淋巴结 全子宫切除术 醋酸甲地孕酮 腔镜 子宫切除 

摘      要：Objective. The purpose of our study was to assess the surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy showed well-differentiated (FIGO grade 1) carcinoma. Materials and methods. A retrospective study was conducted including all women treated at the University of Vermont between 1992 and 2004 whose preoperative endometrial biopsy was reviewed by the staff at the Pathology Department and diagnosed as FIGO grade 1 adenocarcinoma and who received peritoneal washings, total abdominal (or laparoscopic) hysterectomy, bilateral salpingo-oophorectomy,and pelvic ±para-aortic lymphadenectomy as part of their surgery. Results. One hundred eighty-two patients (age: 32-91, median: 60) were enrolled. All patients had total hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, and bilateral pelvic lymphadenectomy. Fifteen (8.2%) patients had para-aortic lymphadenectomy. There were no operative mortalities. Fourteen patients (7.7%)had major operative or postoperative complications. There was disagreement between the pre-and postoperative grade in 30%of the study group. The surgical stages were: IA: 55 (30.2%), IB: 61 (33.5%), IC: 26 (14.3%), IIA: 9 (4.9%), IIB: 8 (4.4%), IIIA: 10 (5.5%), IIIB: 2 (1.1%), IIIC: 8 (4.4%), and IV: 3 (1.6%). Postoperatively, 131 (72%) patients received no additional treatment, 47 (25.8%) received radiation therapy, 3 (1.6%) received chemotherapy, and 1 (0.5%) received Megace. During a median follow-up period of 6 years, 8 (4.4%) patients had recurrence and 6 (3.2%) died from their disease. The 5year disease-free and overall survival was 95.2%and 96.4%, respectively. Conclusions. Approximately 30%of women with endometrial carcinoma whose preoperative endometrial biopsy shows grade 1 tumors have grade 2 or 3 in the hysterectomy specimen and 12.6%have advanced surgical stage (stage III and IV) disease. Women with preoperative endometrial biopsy showing grade 1 tumors who under