Marth C, Koza A, Müller-Holzner E, Hetzel H, Fuith L C, Dapunt O
Universitätsklinik für Frauenheilkunde, Innsbruck, Osterreich.
Geburtshilfe Frauenheilkd. 1990 Aug;50(8):605-9. doi: 10.1055/s-2008-1026309.
In a retrospective analysis of 429 endometrial carcinoma and 29 malignant mixed Müllerian tumour (MMMT) patients, the prognostic factors were evaluated. More than 80% of endometrial carcinomata were staged as I or II, whereas about 30% of MMMT's already in stage III or IV (p less than 0.05). MMMT patients were 10 years older than the carcinoma group (73a vs 63a; p less than 0.001). The risk factors parity, adipositas, and diabetes were equally distributed in the two groups, the survival was worse in MMMT (p less than 0.0001). Applying univariate analysis stage, grading, myometrial invasion and type of therapy significantly affected the survival of endometrial carcinoma patients. After a Cox regression, only stage and grading remained significantly associated with the prognosis. For MMMT's, the survival was also influenced by stage, myometrial invasion, and kind of therapy. Moreover, the parity was found to affect markedly the course of disease. Cox regression of our data excluded all but stage and parity. The beneficial influence of parity on the prognosis of MMMTs, despite a latency of more than 20 years from the last birth to tumour appearance, is unique in oncology.
对429例子宫内膜癌患者和29例恶性苗勒管混合瘤（MMMT）患者进行回顾性分析，评估预后因素。超过80%的子宫内膜癌分期为I期或II期，而约30%的MMMT已处于III期或IV期（p<0.05）。MMMT患者比癌组患者大10岁（73岁对63岁；p<0.001）。危险因素产次、肥胖和糖尿病在两组中分布相同，MMMT患者的生存率较差（p<0.0001）。单因素分析显示，分期、分级、肌层浸润和治疗类型显著影响子宫内膜癌患者的生存率。经过Cox回归分析，只有分期和分级仍与预后显著相关。对于MMMT，生存率也受分期、肌层浸润和治疗方式的影响。此外，发现产次对疾病进程有显著影响。对我们的数据进行Cox回归分析后，除分期和产次外，其他因素均被排除。尽管从最后一次生育到肿瘤出现有超过20年的潜伏期，但产次对MMMT预后的有益影响在肿瘤学中是独特的。
