Department of Obstetrics and Gynecology, Medical School of Ankara University, Ankara, Turkey.
Int J Clin Oncol. 2013 Feb;18(1):105-9. doi: 10.1007/s10147-011-0351-y. Epub 2011 Nov 18.
To assess clinical, surgical and pathologic variables in survival of advanced endometrial cancer.
Sixty-seven advanced-stage (stages III and IV according to FIGO 2009) endometrial cancer cases were evaluated retrospectively. The effects on survival of age, histologic subtype, stage, grade, myometrial invasion, optimal cytoreduction, parity and cervical involvement were analyzed.
Cervical involvement (P = 0.033) and nulliparity (P = 0.042) were worsening features in terms of survival. In 56 cases (83.5%) optimal cytoreduction could be achieved and survival was significantly longer in this group than the group who were not optimally cytoreduced (mean 30.4 vs. 9.6 months) (P < 0.01). Depth of myometrial invasion, histologic type of tumor, stage, grade, and age younger or older than 60 years were not found to be related to survival. Neither adjuvant therapy type nor their combination were superior to each other for improving survival.
Cervical stromal involvement is a poor prognostic factor in cases of advanced endometrial carcinoma. Further studies are required to describe the effect of different surgical approaches such as radical hysterectomy on survival in the presence of cervical stromal invasion.
评估晚期子宫内膜癌患者的临床、手术和病理变量与生存的关系。
回顾性分析了 67 例晚期（FIGO 2009 分期为 III 期和 IV 期）子宫内膜癌患者。分析了年龄、组织学亚型、分期、分级、肌层浸润、最佳肿瘤细胞减灭术、产次和宫颈受累对生存的影响。
宫颈受累（P = 0.033）和未产（P = 0.042）是影响生存的不良特征。在 56 例（83.5%）患者中可以实现最佳肿瘤细胞减灭术，与未进行最佳肿瘤细胞减灭术的患者相比，这组患者的生存时间明显更长（平均 30.4 个月 vs. 9.6 个月）（P < 0.01）。肌层浸润深度、肿瘤组织学类型、分期、分级和年龄小于或大于 60 岁与生存无关。辅助治疗类型及其组合均未显示出优于彼此的优势，无法改善生存。
宫颈间质受累是晚期子宫内膜癌患者的不良预后因素。需要进一步研究描述在存在宫颈间质浸润的情况下，不同手术方法（如根治性子宫切除术）对生存的影响。
