Department of Obstetrics and Gynecology, Hospital Tenon, APHP (Assistance Publique des Hôpitaux de Paris), Paris, France.
Am J Obstet Gynecol. 2012 Jun;206(6):500.e1-11. doi: 10.1016/j.ajog.2012.03.027. Epub 2012 Mar 30.
We sought to evaluate whether patients with endometrial cancer in the Surveillance, Epidemiology, and End Results database who underwent lymphadenectomy demonstrate improved survival.
The study population comprised 50,969 patients. The 3-year cause-specific survival was tested by using propensity score matching (PSM) analysis.
The PSM analysis generated a balanced, matched cohort in which baseline characteristics were not significantly different. The benefit of systematic lymphadenectomy appears to be significant for presumed stage I International Federation of Gynecology and Obstetrics grade 3 cancers and presumed stages II-III cancer. The omission of lymphadenectomy in stage I did not appear to show a deleterious survival consequence if the differentiation grade was moderate (grade 2) or well (grade 1).
Using PSM analysis, our results show no evidence of benefit in terms of survival for systematic lymphadenectomy in women with stage I endometrial cancer, except for grade 3 cancers.
我们旨在评估接受淋巴结切除术的 Surveillance, Epidemiology, and End Results 数据库中子宫内膜癌患者的生存是否得到改善。
研究人群包括 50969 名患者。通过倾向评分匹配（PSM）分析测试 3 年特异性生存。
PSM 分析生成了一个平衡的匹配队列，其中基线特征没有显著差异。系统淋巴结切除术的获益似乎对假定的国际妇产科联合会（FIGO）分级 3 期和假定的 II-III 期癌症具有重要意义。如果分化程度为中度（2 级）或良好（1 级），则在 I 期省略淋巴结切除术似乎不会对生存产生有害影响。
使用 PSM 分析，我们的结果表明，除了 3 级癌症外，对于 I 期子宫内膜癌患者，系统淋巴结切除术在生存方面没有获益证据。
