Department of Obstetrics and Gynecology, Haukeland University Hospital, 5021 Bergen, Norway.
Gynecol Oncol. 2012 May;125(2):381-7. doi: 10.1016/j.ygyno.2012.01.050. Epub 2012 Feb 1.
Age adjusted incidence rate for uterine cancers in Norway has increased over last three decades from 12.2/100.000 (1981-90) to 16.0 (2001-2010). Corresponding 5-year survival increased nationally from 76.3% to 83.3%.
We wanted to investigate how changes in therapeutic strategies during a 30-year period are reflected in survival changes through careful characterization of a population-based series of 1077 endometrial carcinoma patients from Hordaland County, Norway.
In concordance with increase in endometrial cancer nationally, the number of patients treated from Hordaland County rose from 286 (1981-1990) through 307 (1991-2000) to 484 (2001-2010). Main treatment changes included increase in routine pelvic lymphadenectomy from 0% through 9% to 77%, adjuvant chemotherapy from 0% through 3% to 9% and a dramatic reduction in adjuvant radiotherapy from 75% through 48% to 12% (all P<0.001). Body mass index increased significantly during this 30-year period, as did the 5-year disease-specific survival: from 75.8 through 80.2 to 86.9% (P=0.002) and overall survival from 67.8 through 71.7 to 77.8% (P=0.03).
Improved overall and disease specific survival for endometrial carcinoma patients over the last 30 years is demonstrated in a population-based setting. Increasing BMI among patients and a change in treatment strategy with reduction in adjuvant radiotherapy and more extensive surgery is demonstrated for the same period.
在过去的三十年中，挪威的子宫癌年龄调整发病率从 12.2/100.000（1981-90 年）增加到 16.0（2001-2010 年）。相应的 5 年生存率从全国的 76.3%增加到 83.3%。
我们希望通过仔细描述来自挪威霍达兰郡的 1077 名子宫内膜癌患者的基于人群的系列，调查 30 年来治疗策略的变化如何反映在生存变化中。
与全国范围内子宫内膜癌的增加一致，从霍达兰郡治疗的患者数量从 286 人（1981-1990 年）增加到 307 人（1991-2000 年）到 484 人（2001-2010 年）。主要治疗变化包括常规盆腔淋巴结切除术的增加，从 0%到 9%到 77%，辅助化疗从 0%到 3%到 9%，以及辅助放疗的大幅减少，从 75%到 48%到 12%（均 P<0.001）。在此 30 年期间，患者的体重指数显着增加，5 年疾病特异性生存率也随之增加：从 75.8%到 80.2%到 86.9%（P=0.002），总生存率从 67.8%到 71.7%到 77.8%（P=0.03）。
在基于人群的环境中，证明了过去 30 年来子宫内膜癌患者的总体和疾病特异性生存率得到了提高。在同一时期，患者的 BMI 增加以及治疗策略的变化，包括减少辅助放疗和更广泛的手术，也得到了证明。
