Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Gynecol Oncol. 2012 Apr;125(1):99-102. doi: 10.1016/j.ygyno.2011.11.020. Epub 2011 Nov 21.
To evaluate patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial adenocarcinoma.
A prospectively maintained endometrial cancer database was utilized to identify all patients with stage IC endometrioid endometrial adenocarcinoma treated between 2/93 and 6/09. Patterns of recurrence and risk factors were analyzed.
One hundred thirty-four patients with stage IC endometrial cancer were identified. Median age was 66 years (range, 31-91 years). All patients were initially treated surgically, and 79% underwent comprehensive surgical staging with lymphadenectomy. Median number of lymph nodes removed was 18 (range, 1-45). Fifty-one patients (38%) had FIGO grade 1 tumors, 55 (41%) had grade 2 tumors, and 28 (21%) had grade 3 tumors. The majority of patients (91%) received adjuvant radiation therapy. With a median follow-up of 36 months (range, 0.6-141.4 months), 10 patients recurred. Of these, 2 (20%) were grade 1, 2 (20%) were grade 2, and 6 (60%) were grade 3. Nine (90%) of these recurrences had a distant component and 7 (70%) were fatal. Overall, the 3 year cumulative incidence failure rate for grade 1/2 tumors was 5.4%; for grade 3 tumors it was 28.9% (P<0.001). Age, BMI, and lymphovascular invasion were not associated with an increased risk of recurrence.
Patients with stage IC, grade 3 endometrial cancer had a significantly increased risk of recurrence (28.9%). All of these recurrences had a distant component and the majority were fatal. Further investigation into the addition of adjuvant systemic therapy in these high-risk patients is warranted.
评估 1988 年FIGO 分期 IC 型子宫内膜样腺癌的复发模式。
利用前瞻性维护的子宫内膜癌数据库，确定所有 1993 年 2 月至 2009 年 6 月期间接受治疗的分期为 IC 型子宫内膜样腺癌的患者。分析复发模式和危险因素。
共确定了 134 例分期为 IC 的子宫内膜癌患者。中位年龄为 66 岁（范围，31-91 岁）。所有患者最初均接受手术治疗，79%的患者接受了全面的手术分期和淋巴结切除术。中位数切除的淋巴结数量为 18 个（范围，1-45 个）。51 例（38%）患者为FIGO 分级 1 肿瘤，55 例（41%）为分级 2 肿瘤，28 例（21%）为分级 3 肿瘤。大多数患者（91%）接受了辅助放疗。中位随访时间为 36 个月（范围，0.6-141.4 个月），10 例患者复发。其中，2 例（20%）为分级 1，2 例（20%）为分级 2，6 例（60%）为分级 3。这些复发中有 9 例（90%）有远处转移，7 例（70%）为致死性。总体而言，分级 1/2 肿瘤的 3 年累积无失败率为 5.4%；分级 3 肿瘤的无失败率为 28.9%（P<0.001）。年龄、BMI 和脉管侵犯与复发风险增加无关。
分期为 IC、分级为 3 的子宫内膜癌患者复发风险显著增加（28.9%）。这些复发均有远处转移，大多数为致死性。有必要进一步研究在这些高危患者中添加辅助全身治疗。
