Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, 161 Fort Washington Avenue, New York, NY 10032, USA.
Am J Obstet Gynecol. 2011 Mar;204(3):248.e1-7. doi: 10.1016/j.ajog.2010.10.903. Epub 2011 Jan 17.
We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer.
Women with stage I-IIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion ≥50%, cervical stromal involvement, and grade 3 histology.
A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 63-72%) for group 1 (node positive/no RF) vs 69% (95% CI, 66-72%) for group 5 (node negative/multiple RF). Five-year survival was lower for node-positive patients with RF (58%; 95% CI, 54-61%) than node-positive patients without RF (68%; 95% CI, 63-72%).
Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis.
我们研究了与淋巴结转移相比，子宫内膜癌中子宫危险因素（RF）的预后意义。
根据淋巴结是否存在阳性，将 I-IIIC 期子宫内膜样癌患者分层。每位患者的特征为存在的 RF 数量：肌层浸润≥50%、宫颈间质受累和 3 级组织学。
共确定了 26967 名妇女。在多变量模型中，子宫 RF 强烈影响生存，但淋巴结疾病是更重要的负预后因素。组 1（淋巴结阳性/无 RF）的 5 年总生存率为 68%（95%CI，63-72%），组 5（淋巴结阴性/多个 RF）为 69%（95%CI，66-72%）。有 RF 的淋巴结阳性患者的 5 年生存率（58%；95%CI，54-61%）低于无 RF 的淋巴结阳性患者（68%；95%CI，63-72%）。
子宫 RF 无论在存在或不存在淋巴结转移的情况下，均强烈影响生存。
