Descamps P, Calais G, Vitu L, Body G, Lansac J, Le Floch O
Clinique d'Oncologie et Radiothérapie, Hôpital Bretonneau, CHRU, Tours.
J Gynecol Obstet Biol Reprod (Paris). 1991;20(2):223-9.
In our institution endometrial carcinomas stage I and II were treated with uterovaginal brachytherapy and radical hysterectomy with pelvic lymphadenectomy. We have studied in a retrospective analysis the results of the lymphadenectomy in order to precise his place in the treatment strategy. Between 1976 and 1986, 155 patients were treated these modalities (107 were stage I, 48 were stage II). The mean age was 60.2 years. Brachytherapy delivered 60 Gy and then radical hysterectomy with pelvic lymphadenectomy was performed. 26 patients received a pelvic external beam irradiation on account of lymph node involvement and or deep tumor invasion into the myometrium. 14 patients (9%) had a lymph node involvement. External iliac lymph nodes were involved in 78.5% of these cases. Lymph node involvement rate was higher for stage II, grade 3 tumors and when there was a deep tumor invasion into the myometrium. Pelvic failure rate was 12% for N- patients and 36% for N+ patients. Five years actuarial survival rate was 83% for N- and 41% for N+ patients. Now, we carry out a pelvic external radiotherapy for all stage II, grade 2 or 3 patients and when there is a deep tumor invasion into the myometrium and we do not perform lymphadenectomy for these patients. We perform only external iliac sample for patients with stage I grade 1 tumour without deep tumour invasion.
在我们机构，I期和II期子宫内膜癌采用子宫阴道近距离放疗及根治性子宫切除术加盆腔淋巴结清扫术进行治疗。我们通过回顾性分析研究了淋巴结清扫术的结果，以明确其在治疗策略中的地位。1976年至1986年间，155例患者接受了这些治疗方式（I期107例，II期48例）。平均年龄为60.2岁。先进行60 Gy的近距离放疗，然后施行根治性子宫切除术加盆腔淋巴结清扫术。26例患者因淋巴结受累和/或肿瘤深度浸润肌层而接受盆腔外照射。14例患者（9%）有淋巴结受累。其中78.5%的病例髂外淋巴结受累。II期、3级肿瘤以及肿瘤深度浸润肌层时，淋巴结受累率更高。N-患者的盆腔失败率为12%，N+患者为36%。N-患者的5年精算生存率为83%，N+患者为41%。现在，对于所有II期、2级或3级患者以及肿瘤深度浸润肌层的患者，我们进行盆腔外放疗，且不对这些患者进行淋巴结清扫术。对于I期1级且无肿瘤深度浸润的患者，我们仅采集髂外淋巴结样本。
