Lee Christine M, Slomovitz Brian M, Greer Marilyn, Sharma Sheena, Gregurich Mary Ann, Burke Thomas, Lu Karen H, Ramondetta Lois M
Department of Gynecologic Oncology, Division of Surgery, Unit 440, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA.
Gynecol Oncol. 2005 Jul;98(1):77-83. doi: 10.1016/j.ygyno.2005.03.033.
The purpose of surgical staging is to better determine prognosis and treatment. The International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer is a heterogenous disease, and adjuvant therapy is not well-defined. The aim of this study was to survey the Society of Gynecologic Oncologists (SGO) members and fellows about their approach to the treatment of patients with stage IIIA endometrial cancer.
All 850 members of the SGO were mailed surveys that asked how they would manage various case scenarios of stage IIIA endometrial cancer. Data were collected using an Internet survey database. Frequency distributions were determined, and nonparametric tests were performed.
Fifty-three percent of SGO members and fellows responded. For the treatment of stage IIIA disease with malignant cytology only, adjuvant therapy was recommended 46%, 62%, and 98% of the time for women with grades 1, 2, and UPSC, respectively. Sixty-six percent of respondents would not remove malignant cytology from the current staging criteria. Ninety-nine percent of respondents recommended adjuvant therapy for patients with adnexal or serosal involvement. Eighty-six percent indicated that a hysteroscopy for diagnosis would not alter their treatment recommendations.
While most gynecologic oncologists in our survey recommend adjuvant therapy for stage IIIA endometrial carcinoma, our results showed that patients with malignant cytology only would receive different treatments than patients with adenxal or serosal involvement. Histology and grade of the tumor are predictors of therapy recommendations over malignant cytology. Most respondents agreed that patients with malignant cytology should remain in stage IIIA.
手术分期的目的是更好地确定预后和治疗方案。国际妇产科联盟（FIGO）ⅢA期子宫内膜癌是一种异质性疾病，辅助治疗尚无明确界定。本研究旨在调查妇科肿瘤学会（SGO）成员及学员对ⅢA期子宫内膜癌患者的治疗方法。
向SGO的所有850名成员邮寄调查问卷，询问他们对ⅢA期子宫内膜癌各种病例情况的处理方式。数据通过互联网调查数据库收集。确定频率分布并进行非参数检验。
53%的SGO成员及学员回复了问卷。对于仅伴有恶性细胞学检查结果的ⅢA期疾病的治疗，对于1级、2级和子宫浆液性乳头状癌（UPSC）的女性患者，分别有46%、62%和98%的情况推荐辅助治疗。66%的受访者不会将恶性细胞学检查结果从当前分期标准中去除。99%的受访者推荐对附件或浆膜受累患者进行辅助治疗。86%的受访者表示宫腔镜检查用于诊断不会改变他们的治疗建议。
虽然我们调查中的大多数妇科肿瘤学家推荐对ⅢA期子宫内膜癌进行辅助治疗，但我们的结果表明，仅伴有恶性细胞学检查结果的患者与附件或浆膜受累患者会接受不同的治疗。肿瘤的组织学类型和分级是比恶性细胞学检查结果更能预测治疗建议的因素。大多数受访者同意伴有恶性细胞学检查结果的患者应仍归为ⅢA期。
