Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Gynecol Oncol. 2011 Mar 31;22(1):3-8. doi: 10.3802/jgo.2011.22.1.3.
Few studies on the prognosticators of the patients with recurrent endometrial cancer after relapse have been reported in the literature. The aim of this study was to determine the prognosticators after relapse in patients with recurrent endometrial cancer who underwent primary complete cytoreductive surgery and adjuvant chemotherapy.
Thirty-five patients with recurrent endometrial cancer were included in this retrospective analysis. The prognostic significance of several clinicopathological factors including histologic type, risk for recurrence, time to relapse after primary surgery, number of relapse sites, site of relapse, treatment modality, and complete resection of recurrent tumors were evaluated. Survival analyses were performed by Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis.
Among the clinicopathological factors analyzed, histologic type (p=0.04), time to relapse after primary surgery (p=0.03), and the number of relapse sites (p=0.03) were significantly related to survival after relapse. Multivariate analysis revealed that time to relapse after primary surgery (hazard ratio, 6.8; p=0.004) and the number of relapse sites (hazard ratio, 11.1; p=0.002) were independent prognostic factors for survival after relapse. Survival after relapse could be stratified into three groups by the combination of two independent prognostic factors.
We conclude that time to relapse after primary surgery, and the number of relapse sites were independent prognostic factors for survival after relapse in patients with recurrent endometrial cancer.
文献中鲜有报道复发后子宫内膜癌患者的预后因素。本研究旨在确定行初次完全减瘤术和辅助化疗的复发性子宫内膜癌患者复发后的预后因素。
回顾性分析 35 例复发性子宫内膜癌患者。评估了组织学类型、复发风险、初次手术后复发时间、复发部位数量、复发部位、治疗方式以及复发性肿瘤完全切除等几个临床病理因素的预后意义。采用 Kaplan-Meier 曲线和对数秩检验进行生存分析。采用多变量 Cox 回归分析确定独立的预后因素。
在分析的临床病理因素中,组织学类型(p=0.04)、初次手术后复发时间(p=0.03)和复发部位数量(p=0.03)与复发后的生存显著相关。多变量分析显示,初次手术后复发时间(风险比,6.8;p=0.004)和复发部位数量(风险比,11.1;p=0.002)是复发后生存的独立预后因素。通过两个独立预后因素的组合,复发后生存可分为三组。
我们的结论是,初次手术后的复发时间和复发部位数量是复发性子宫内膜癌患者复发后生存的独立预后因素。