Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands.
Gynecol Oncol. 2010 Apr;117(1):32-6. doi: 10.1016/j.ygyno.2009.12.010. Epub 2010 Jan 8.
The aim of this study was to look at the impact of the number of sites with tumour involvement on outcome for patients with stage IIIA endometrioid-type endometrial carcinoma.
141 patients stage IIIA were included. A central histopathological review was performed. Patients staged solely on the presence of a positive peritoneal washing were excluded. Follow-up ranged from 2 to 217 months with a median of 43 months. Endpoints of the study were locoregional recurrence rates, distant metastasis-free survival (DMFS), disease-free survival (DFS) and disease-specific survival (DSS).
In multivariate analyses the number of involved sites showed to be the only independent significant variable for DMFS, DFS, and DSS with a Hazard Ratio of 2.1, 2.2, and 2.2, respectively. The DSS was significantly related to the number of involved sites, with a 5-year DSS of 70.4% for one site, 42.8% for two sites, and 43.9% for three sites, respectively (p=0.001).
The number of involved sites outside the corpus uterine for stage IIIA seems to be a strong negative prognostic factor for stage IIIA endometrial carcinoma.
本研究旨在探讨 IIIA 期子宫内膜样型子宫内膜癌患者肿瘤累及部位数量对其预后的影响。
纳入 141 例 IIIA 期患者。进行了中心病理复查。仅因阳性腹膜灌洗液而分期的患者被排除在外。随访时间为 2 至 217 个月，中位数为 43 个月。本研究的终点为局部区域复发率、无远处转移生存率（DMFS）、无病生存率（DFS）和疾病特异性生存率（DSS）。
在多变量分析中，累及部位数量是 DMFS、DFS 和 DSS 的唯一独立显著变量，风险比分别为 2.1、2.2 和 2.2。DSS 与累及部位数量显著相关，5 年 DSS 分别为 1 个部位为 70.4%、2 个部位为 42.8%、3 个部位为 43.9%（p=0.001）。
III 期子宫内膜癌患者子宫外累及部位数量似乎是一个强烈的预后不良因素。
