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[子宫内膜样子宫内膜癌——选定临床和病理参数的预后价值]

[Endometrioid endometrial cancer--the prognostic value of selected clinical and pathological parameters].

作者信息

Gottwald Leszek, Chałubińska Justyna, Moszyńska-Zielińska Małgorzata, Piekarski Janusz, Tyliński Wiesław, Szwalski Jarosław, Kubiak Robert, Pasz-Walczak Grazyna, Hendzel Katarzyna, Ciałkowska-Rysz Aleksandra

机构信息

Pracownia Medycyny Paliatywnej Katedry Onkologii, Uniwersytet Medyczny w Łodzi, Polska.

出版信息

Ginekol Pol. 2011 Oct;82(10):743-8.

Abstract

OBJECTIVES

To assess the relationship between selected clinical and pathological factors and disease free survival (DFS) and overall survival (OS) in endometrioid endometrial cancer patients.

MATERIAL AND METHODS

A retrospective review of 262 patients aged 37-86 (6.0 +/- 9.0) was performed. Selected clinical and pathological data were correlated with DFS and OS.

RESULTS

Follow-up was 8-123 months (64.9 +/- 27.1). In 4 patients (1.5%) clinical progression was diagnosed during the treatment. In 43 patients (16.4%) relapse was diagnosed 2-61 months (23.9 +/- 15.7) after commencing treatment. DFS and OS were 82.1% and 81.3% respectively. In univariate analysis worse DFS was related to older patients (p = 0.007) and non-radical surgery (p < 0.001). In multivariate analysis worse DFS was related to older patients (HR = 1.058; 95% CI = 1.024-1.093; p < 0.001), younger at menopause (HR = 0.910; 95% CI = 0.851-0.973; p = 0.006), with higher staging (HR = 2.639; 95% CI = 1.968-3.539; p < 0.001) operated non-radically (HR = 0.220; 95% CI = 0.096-0.504; p < 0.001). In univariate analysis worse OS was connected with older patients (p = 0.018), diabetes type II (p = 0.019) and non-radical surgery (p < 0.001). In multivariate analysis worse OS was related to younger age at menopause (HR = 0.932; 95% CI = 0.873-0.996; p = 0.039), diabetes type II (HR = 2.372; 95% CI = 1.260-4.466; p = 0.008), higher staging (HR = 2.053; 95% CI = 1.482-2.845; p < 0.001), and non-radical surgery (HR = 0.240; 95% CI = 0.091-0.636; p = 0.004).

CONCLUSIONS

Relapsed endometrial cancer developed in 90.7% during four years after commencing treatment. In 79.1% of these patients distant metastases were present. Most significant prognostic factors were radicality of surgery age of patients and staging. The presence of diabetes type II and early menopause were connected with worse prognosis.

摘要

目的

评估子宫内膜样腺癌患者某些临床和病理因素与无病生存期(DFS)及总生存期(OS)之间的关系。

材料与方法

对262例年龄在37 - 86岁(平均6.0±9.0岁)的患者进行回顾性研究。选取临床和病理数据并与DFS及OS进行关联分析。

结果

随访时间为8 - 123个月(平均64.9±27.1个月)。4例患者(1.5%)在治疗期间被诊断为临床进展。43例患者(16.4%)在开始治疗后2 - 61个月(平均23.9±15.7个月)被诊断为复发。DFS和OS分别为82.1%和81.3%。单因素分析显示,较差的DFS与老年患者(p = 0.007)及非根治性手术(p < 0.001)相关。多因素分析显示,较差的DFS与老年患者(风险比[HR]=1.058;可信区间[CI]=1.024 - 1.093;p < 0.001)、绝经年龄较小(HR = 0.910;95%CI = 0.851 - 0.973;p = 0.006)、分期较高(HR = 2.639;95%CI = 1.968 - 3.539;p < 0.001)及非根治性手术(HR = 0.220;95%CI = 0.096 - 0.504;p < 0.001)有关。单因素分析显示,较差的OS与老年患者(p = 0.018)、II型糖尿病(p = 0.019)及非根治性手术(p < 0.001)相关。多因素分析显示,较差的OS与绝经年龄较小(HR = 0.932;95%CI = 0.873 - 0.996;p = 0.039)、II型糖尿病(HR = 2.372;95%CI = 1.260 - 4.466;p = 0.008)、分期较高(HR = 2.053;95%CI = 1.482 - 2.845;p < 0.001)及非根治性手术(HR = 0.240;95%CI = 0.091 - 0.636;p = 0.004)有关。

结论

90.7%的复发性子宫内膜癌在开始治疗后四年内发生。其中79.1%的患者出现远处转移。最重要的预后因素是手术根治性、患者年龄和分期。II型糖尿病的存在及绝经早与较差的预后相关。

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