Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2012 Aug;91(8):976-82. doi: 10.1111/j.1600-0412.2012.01438.x. Epub 2012 Jun 18.
To present Danish national survival data on women with early stage endometrial cancer and use these data to discuss the relevance of postoperative follow-up.
Prospective study.
Danish Endometrial Cancer Study (DEMCA).
Five hundred and seventy-one FIGO stage IA (1988 classification) endometrial cancer patients prospectively included between 1986 and 1999. All patients had total abdominal hysterectomy and bilateral salpingo-oophorectomy without adjuvant therapy.
The patient and the disease characteristics were drawn from the DEMCA database with cross-references to the national death registry and the national pathology database. Statistical methods included Kaplan-Meier, log-rank and Cox regression analysis.
Survival rates in relation to histopathology.
The five year overall survival rate was 88.9% and five year disease-specific survival was 97.3%. Patients with low- (91.8%) and high-risk histopathology (8.2%) were compared. The age-adjusted overall and disease-specific survival differed significantly between women with low- and high-risk histopathology (p = 0.039 and p = 0.004, respectively). The disease-specific survival adjusted for age between patients with well-differentiated endometrioid tumors differed from those with moderately differentiated tumors (p = 0.008, hazard ratio = 3.75, 95% confidence interval 1.41-10.00). Recurrence data were available on 464 patients. Twenty-three (3.9%) experienced recurrence. Of these recurrences, 15 of 23 (65%) were vaginal. Death from recurrence was observed in nine of 23 (39%) patients, and five of these nine had vaginal recurrences.
Women with FIGO stage IA endometrial cancer have a very high disease-specific five year survival. Survival was related to histopathology. Follow-up at a highly specialized tertiary care center for patients with an extremely good prognosis may be questioned.
呈现丹麦早期子宫内膜癌女性患者的全国生存率数据，并利用这些数据探讨术后随访的相关性。
前瞻性研究。
丹麦子宫内膜癌研究（DEMCA）。
1986 年至 1999 年期间，571 名国际妇产科联合会（FIGO）IA 期（1988 年分类）子宫内膜癌患者前瞻性纳入。所有患者均接受了全子宫切除术和双侧输卵管卵巢切除术，未接受辅助治疗。
患者和疾病特征来自 DEMCA 数据库，并与国家死亡登记处和国家病理数据库交叉引用。统计方法包括 Kaplan-Meier、对数秩和 Cox 回归分析。
生存率与组织病理学的关系。
五年总生存率为 88.9%，五年疾病特异性生存率为 97.3%。比较了低危（91.8%）和高危组织病理学患者（8.2%）。低危和高危组织病理学患者的年龄调整后总生存率和疾病特异性生存率差异显著（p=0.039 和 p=0.004）。年龄调整后的疾病特异性生存率在分化良好的子宫内膜样肿瘤患者和中分化肿瘤患者之间存在显著差异（p=0.008，风险比=3.75，95%置信区间 1.41-10.00）。可获得 464 例患者的复发数据。23 例（3.9%）出现复发。其中 23 例中的 15 例（65%）为阴道复发。23 例中有 9 例（39%）因复发而死亡，其中 5 例为阴道复发。
FIGO 分期 IA 期子宫内膜癌患者的疾病特异性五年生存率非常高。生存率与组织病理学相关。对于预后极好的患者，在高度专业化的三级保健中心进行随访可能值得质疑。
