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同时检测到的原发性子宫内膜癌和卵巢癌的临床病理观察。

Clinicopathologic insight of simultaneously detected primary endometrial and ovarian carcinomas.

机构信息

1st Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Alexandra Hospital, University of Athens, 17, Eslin str., 11523 Athens, Greece.

出版信息

Arch Gynecol Obstet. 2012 Mar;285(3):817-21. doi: 10.1007/s00404-011-2046-z. Epub 2011 Aug 14.

Abstract

PURPOSE

To evaluate the clinicopathologic features in patients with synchronous primary carcinomas of the ovary and endometrium.

METHODS

Clinical information and pathologic details were collected and analyzed from 30 women with synchronous endometrial and ovarian cancers.

RESULTS

Median age at diagnosis was 51 years. Abnormal uterine bleeding was the most common presenting symptom (50%). More than half (53%) of the patients were premenopausal and 37% never had a pregnancy. Stage I disease was observed in 90 (27/30) and 73% (22/30) of the patients with endometrial and ovarian cancer, respectively. Endometrioid type was the most frequently observed histology for synchronous endometrial and ovarian cancer (n = 18/30, 60%). All patients were surgically staged and adjuvant treatment was considered when required according to our protocols. The mean follow-up period was 6.6 years (SD = 3.0 years), and the cumulative event-free rate for 5 years was 84.2% (SE 7.3%). No significant differences in the survival rates were found according to the histological subtype (p = 0.513). Women with synchronous primary cancers of the endometrium and ovary were generally younger than those developing either one of the above mentioned adenocarcinomas. They appeared to have a favorable prognosis with an estimated overall survival of 84.2% in 5 years.

CONCLUSIONS

A gynecologist should always keep in mind the possibility of double primary carcinomas of the endometrium and ovary in a young, premenopausal, nulliparous woman presenting with abnormal uterine bleeding and prompt the patient for further evaluation.

摘要

目的

评估卵巢和子宫内膜同时发生原发性癌的临床病理特征。

方法

从 30 名患有同时性子宫内膜和卵巢癌的女性中收集并分析临床信息和病理细节。

结果

诊断时的中位年龄为 51 岁。异常子宫出血是最常见的表现症状(50%)。超过一半(53%)的患者处于绝经前,37%的患者从未怀孕过。Ⅰ期疾病分别在 90 名(27/30)和 73%(22/30)的子宫内膜和卵巢癌患者中观察到。同时性子宫内膜和卵巢癌最常观察到的组织学类型是子宫内膜样型(n = 18/30,60%)。所有患者均进行手术分期,并根据我们的方案在需要时考虑辅助治疗。平均随访时间为 6.6 年(SD = 3.0 年),5 年无事件生存率为 84.2%(SE 7.3%)。根据组织学亚型,生存率无显著差异(p = 0.513)。同时患有子宫内膜和卵巢原发性癌的女性通常比那些患有上述任何一种腺癌的女性更年轻。她们的预后似乎较好,5 年总生存率估计为 84.2%。

结论

妇科医生应始终牢记年轻、绝经前、未生育、伴有异常子宫出血的女性同时发生子宫内膜和卵巢双原发性癌的可能性,并促使患者进一步评估。

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