Held E
Arch Gynakol. 1977 Jul 8;222(4):295-309. doi: 10.1007/BF02570656.
A long experience in the treatment of endometrial cancer shows that the therapeutic measures vary considerably with regard to the extention of the tumor, the age of the patient and her general condition. This circumstances and particularly the critical study of the therapeutical results give the limits, within a certain kind of operation can reasonably be recommended. The intercurrent deaths are an important factor in the statistical evaluation of therapeutical success. As long as the tumor is limited to the body of the uterus, the corrected 5-year recoveries are about 90%. Considering all the circumstances, it becomes obvious, that in this stage, the simple abdominal hysterectomy with removal of the adnexa is still the operation of choice. Beside the histological degree of differentiation, the depth of the muscular invasion is the most important prognostic factor which might lead to additional measures. Postoperative radiation therapy of the vagina reduces considerably the incidence possibility of vaginal apex recurrence. In stage II radical hysterectomy must be considered, although we are aware of the fact, that a simple hysterectomy and bilateral salpingo-oophorectomy combined with radiation treatment may yield just as good results. In the clinical stage III laparotomy ought to be used more frequently. Also in case of operative intervention additional radiotherapy is mostly useful.
长期治疗子宫内膜癌的经验表明,治疗措施会因肿瘤的扩散程度、患者年龄及其一般状况而有很大差异。这种情况,尤其是对治疗结果的批判性研究,给出了在何种范围内可以合理推荐某种手术的界限。术中死亡是治疗成功统计评估中的一个重要因素。只要肿瘤局限于子宫体,校正后的5年治愈率约为90%。综合考虑所有情况,很明显,在这个阶段,单纯经腹子宫切除术加附件切除仍是首选手术。除了组织学分化程度外,肌层浸润深度是最重要的预后因素,可能需要采取额外措施。术后对阴道进行放射治疗可大大降低阴道顶端复发的可能性。在II期,必须考虑根治性子宫切除术,尽管我们知道,单纯子宫切除术加双侧输卵管卵巢切除术联合放射治疗可能会产生同样好的效果。在临床III期,剖腹手术应更频繁地使用。在手术干预的情况下,额外的放射治疗通常也很有用。