淋巴结切除术增加了修订后的 2009FIGO 分期系统对子宫内膜癌的预后价值：一项多中心研究。

Lymphadenectomy increases the prognostic value of the revised 2009 FIGO staging system for endometrial cancer: a multi-center study.

机构信息

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yeongeon-Dong, Jongno-Gu, Seoul 110-744, Republic of Korea.

出版信息

Eur J Surg Oncol. 2012 Mar;38(3):230-7. doi: 10.1016/j.ejso.2011.12.023. Epub 2012 Jan 13.

DOI:10.1016/j.ejso.2011.12.023

PMID:22244682

Abstract

BACKGROUND

We investigated whether pelvic or para-aortic lymphadenectomy increases the prognostic value of the revised 2009 FIGO staging system in patients with endometrial cancer (EC).

METHODS

We reviewed 786 patients with EC from six tertiary medical centers between July 1996 and June 2008. All patients were classified according to the 1988 FIGO staging system: IA (n = 234); IB (n = 270); IC (n = 109); IIA (n = 35); IIB (n = 29); IIIA (n = 37); IIIB (n = 3); IIIC (n = 69), and the revised 2009 FIGO staging system was also applied to divide them: IA (=542); IB (=125); II (n = 29); IIIA (n = 18); IIIB (n = 3); IIIC1 (n = 43); IIIC2 (n = 26). Prognostic values between the 1988 and the revised 2009 FIGO staging systems were compared by multivariate Cox's proportional hazard analysis.

RESULTS

The 1988 FIGO stage IC, IIB, IIIA + IIIB and IIIC, and the revised 2009 FIGO stage IB, II, IIIA + IIIB and IIIC2 diseases were prognostic factors for poor PFS, whereas the 1988 FIGO stage IIB and IIIC, and the revised 2009 FIGO stage II, IIIA + IIIB and IIIC2 diseases were unfavorable prognostic factors for OS. Although these results were similar to those in 595 patients who underwent pelvic or para-aortic lymphadenectomy, the revised 2009 FIGO stage IIIC1 disease was an additional prognostic factor for poor PFS and OS (adjusted HRs, 4.19 and 11.25; 95% CIs, 1.39-12.60 and 2.23-36.74).

CONCLUSIONS

The revised 2009 FIGO staging system had a higher prognostic value than the 1988 FIGO staging system, and pelvic or para-aortic lymphadenectomy increased the prognostic value of the revised 2009 FIGO staging system for EC.

摘要

背景

我们研究了盆腔或腹主动脉旁淋巴结清扫术是否会增加修订后的 2009 年 FIGO 分期系统在子宫内膜癌（EC）患者中的预后价值。

方法

我们回顾了 1996 年 7 月至 2008 年 6 月期间来自 6 个三级医疗中心的 786 例 EC 患者。所有患者均按 1988 年 FIGO 分期系统进行分类：IA（n=234）；IB（n=270）；IC（n=109）；IIA（n=35）；IIB（n=29）；IIIA（n=37）；IIIB（n=3）；IIIC（n=69），并应用修订后的 2009 年 FIGO 分期系统对其进行了分类：IA（=542）；IB（=125）；II（n=29）；IIIA（n=18）；IIIB（n=3）；IIIC1（n=43）；IIIC2（n=26）。通过多变量 Cox 比例风险分析比较 1988 年和修订后的 2009 年 FIGO 分期系统的预后价值。

结果

1988 年 FIGO 分期 IC、IIB、IIIA+IIIB 和 IIIC 以及修订后的 2009 年 FIGO 分期 IB、II、IIIA+IIIB 和 IIIC2 疾病是无进展生存期不良的预后因素，而 1988 年 FIGO 分期 IIB 和 IIIC 以及修订后的 2009 年 FIGO 分期 II、IIIA+IIIB 和 IIIC2 疾病是总生存期不良的预后因素。尽管这些结果与 595 例接受盆腔或腹主动脉旁淋巴结清扫术的患者相似，但修订后的 2009 年 FIGO 分期 IIIC1 疾病是无进展生存期和总生存期不良的另一个预后因素（调整后的 HRs，4.19 和 11.25；95%CI，1.39-12.60 和 2.23-36.74）。