Campus Bio-Medico, University of Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):539-43. doi: 10.1016/j.ejogrb.2013.07.037. Epub 2013 Aug 7.
To compare the quality of life (QoL) of women affected by endometrial cancer treated with surgery with or without systematic lymphadenectomy.
Consecutive patients affected by stages I and II endometrial cancer and treated with surgery between 2008 and 2011 were selected. Eligible subjects were divided into two groups: Group A consisted of 36 patients who had hysterectomy plus bilateral salpingo-oophorectomy without lymphadenectomy; Group B consisted of 40 patients who had hysterectomy plus salpingo-oophorectomy plus pelvic and aortic lymphadenectomy. The EORTC Quality of Life Questionnaire-Cancer Module (QLQ-C30) and Quality of Life Questionnaire-Endometrial Cancer Module (QLQ-EN24) were administered to selected patients. All data were recorded and then analyzed using the scoring manual of the EORTC Quality of Life Group.
Among symptom scales, only lymphedema gave a statistically significant difference among two groups, with a score of 10.64 ± 17.43 in Group A and 21.66 ± 24.51 in Group B (p=0.0285). The p value obtained comparing the "Global Health Status" (items 29 and 30) in Group A and in Group B was not statistically significant.
Lymphadenectomy did not influence negatively global health status, but lymphadenectomy maintained its importance in determining a patient's prognosis and in tailoring adjuvant therapies. We therefore support its practice as part of the surgical procedure in patients affected by high risk endometrial cancer.
比较手术治疗伴或不伴系统淋巴结清扫的子宫内膜癌患者的生活质量(QoL)。
选择了 2008 年至 2011 年间接受手术治疗的 I 期和 II 期子宫内膜癌患者。符合条件的患者被分为两组:A 组 36 例患者接受子宫切除术加双侧输卵管卵巢切除术而不进行淋巴结清扫;B 组 40 例患者接受子宫切除术加输卵管卵巢切除术加盆腔和主动脉淋巴结清扫。对选定的患者使用 EORTC 生活质量问卷-癌症模块(QLQ-C30)和生活质量问卷-子宫内膜癌模块(QLQ-EN24)进行问卷调查。记录所有数据,然后使用 EORTC 生活质量组的评分手册进行分析。
在症状量表中,只有淋巴水肿在两组之间存在统计学差异,A 组评分为 10.64 ± 17.43,B 组评分为 21.66 ± 24.51(p=0.0285)。比较 A 组和 B 组的“全球健康状况”(项目 29 和 30)的 p 值没有统计学意义。
淋巴结清扫术并没有对整体健康状况产生负面影响,但它在确定患者的预后和制定辅助治疗方案方面仍然很重要。因此,我们支持在高危子宫内膜癌患者的手术过程中进行淋巴结清扫术。