Piver M S, Hempling R E
Department of Gynecologic Oncology, Roswell Park Memorial Institute, Buffalo, New York 14263.
Cancer. 1990 Sep 15;66(6):1133-8. doi: 10.1002/1097-0142(19900915)66:6<1133::aid-cncr2820660610>3.0.co;2-h.
A prospective trial was performed to evaluate the recurrence rate and 5-year disease-free survival rate in patients with surgical Stage I endometrial adenocarcinoma. Patients with Stage I, Grade 1 or 2 disease, less than 50% myometrial invasion, and no evidence of disease outside the corpus of the uterus were treated by hysterectomy and bilateral salpingo-oophorectomy and postoperative vaginal radium/cesium (Group 1). Patients with surgical Stage I, Grade 3 disease or deep myometrial invasion, and histologically negative paraaortic lymph nodes were treated with postoperative pelvic radiation therapy (5000-5040 cGY) (Group 2). Patients with malignant peritoneal cytologic findings also received progesterone therapy. Of the 92 Group 1 patients, there have been no recurrences and the 5-year estimated disease-free survival rate was 99%. Of the 41 Group 2 patients, there have been four (9.7%) recurrences but only one (2.4%) within the treated field (pelvis), and the 5-year estimated disease-free survival rate was 88%. Of the 133 patients, the 5-year estimated disease-free survival rate was 96%, and only one patient (0.7%) had a local pelvic recurrence. Of the 16 patients with malignant peritoneal cytologic findings who were treated with progesterone therapy, none has had a recurrence.
进行了一项前瞻性试验，以评估手术分期为I期的子宫内膜腺癌患者的复发率和5年无病生存率。I期、1级或2级疾病、肌层浸润小于50%且子宫体以外无疾病证据的患者接受子宫切除术和双侧输卵管卵巢切除术以及术后阴道镭/铯治疗（第1组）。手术分期为I期、3级疾病或肌层深度浸润且组织学检查腹主动脉旁淋巴结阴性的患者接受术后盆腔放射治疗（5000 - 5040 cGY）（第2组）。有恶性腹腔细胞学检查结果的患者也接受孕激素治疗。在92例第1组患者中，无复发情况，5年估计无病生存率为99%。在41例第2组患者中，有4例（9.7%）复发，但仅1例（2.4%）在治疗区域（盆腔）内复发，5年估计无病生存率为88%。在133例患者中，5年估计无病生存率为96%，只有1例患者（0.7%）出现局部盆腔复发。在接受孕激素治疗的16例有恶性腹腔细胞学检查结果的患者中，无复发情况。
