Homesley H D, Boronow R C, Lewis J L
Obstet Gynecol. 1976 Jan;47(1):100-5.
This retrospective study of patients receiving initial therapy for endometrial adenocarcinoma at Memorial-James Ewing Hospitals from 1949-1965 confirmed that the most important factor related to survival was extent of disease at presentation. Those patients with spread beyond the corpus had a much poorer prognosis regardless of method of therapy. Within Stage I, histologic grade and depth of myometrial penetration were of much greater prognostic significance than uterine size. Advanced age was associated with a higher incidence of poorly differentiated tumors. Apparently for Stage I, simple hysterectomy alone was not as effective as simple hysterectomy combined with preoperative radium or radical hysterectomy with or without node dissection. There was a 6% incidence of positive nodes when node dissection was performed in Stage I patients who had no spread of disease to the cervix confirmed at operation. Pure vaginal recurrence rate was low for all methods of therapy in Stage I. Eradication of recurrences by any means was relatively ineffective.
这项对1949年至1965年在纪念-詹姆斯·尤因医院接受子宫内膜腺癌初始治疗的患者进行的回顾性研究证实，与生存相关的最重要因素是就诊时疾病的范围。那些病变超出子宫体的患者，无论采用何种治疗方法，预后都要差得多。在I期患者中，组织学分级和肌层浸润深度比子宫大小具有更大的预后意义。高龄与低分化肿瘤的发生率较高有关。显然，对于I期患者，单纯子宫切除术不如单纯子宫切除术联合术前镭疗或根治性子宫切除术（无论是否进行淋巴结清扫）有效。在I期患者中，术中证实疾病未扩散至宫颈的患者进行淋巴结清扫时，淋巴结阳性发生率为6%。I期患者所有治疗方法的单纯阴道复发率都很低。通过任何手段根除复发相对无效。
