Li Lin, Wu Lingying, Zhang Rong, Zhang Gongyi, Li Ning, Li Xiaoguang, Yuan Guangwen
Department of Gynecologic Oncology, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.
Department of Gynecologic Oncology, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China. Email:
Zhonghua Fu Chan Ke Za Zhi. 2014 Apr;49(4):260-4.
To investigate the safety of ovarian preservation for stage I endometrial carcinomas in women aged 40 years and younger.
Seventy-five cases of stage I endometrial cancer aged 40 years and younger from Jan 1999 to Jan 2012 were treated in Cancer Hospital, Chinese Academy of Medical Sciences. They were further divided into two groups: 20 patients who underwent ovarian preservation (group A) and 55 patients who underwent oophorectomy (group B). Clinical and pathological recordings of these patients were reviewed and compared.
In the group A, there were 13 patients preserved both ovaries, and 7 patients preserved a single ovary. While there were no significant differences in the age, body mass index, surgical staging, histology, grade, cytology of peritoneal lavage or ascites, and postoperative treatment between two groups (all P > 0.05). The differences in the level of CA125 [25% (5/20) versus 18% (10/55)] and number of patients underwent pelvic lymphadenectomy [35% (7/20) versus 84% (46/55)] were statistically significant between two groups (all P < 0.05). Of seventy-five cases, only two patients relapsed and all survived after a median follow-up time of 31.7 months (range: 0 to 160 months). Kaplan-Meier analysis revealed no difference in overall survival (100.0% versus 100.0%) and disease free survival (90.0% versus 95.5%) between two groups (P = 0.579).
Ovarian preservation has no statistically significant impact on the survival of young patients with stage Ia, well differentiated endometrial cancer. Large-scale, prospective clinical studies are needed to validate the safety of ovarian preservation for those patients.
探讨40岁及以下Ⅰ期子宫内膜癌患者保留卵巢的安全性。
对1999年1月至2012年1月在中国医学科学院肿瘤医院治疗的75例40岁及以下的Ⅰ期子宫内膜癌患者进行研究。将患者进一步分为两组：20例行保留卵巢手术的患者（A组）和55例行卵巢切除术的患者（B组）。回顾并比较两组患者的临床和病理记录。
A组中，13例患者保留双侧卵巢，7例患者保留单侧卵巢。两组患者在年龄、体重指数、手术分期、组织学类型、分级、腹腔冲洗液或腹水的细胞学检查以及术后治疗方面均无显著差异（均P>0.05）。两组患者的CA125水平[25%（5/20）对18%（10/55）]和接受盆腔淋巴结清扫术的患者数量[35%（7/20）对84%（46/55）]差异具有统计学意义（均P<0.05）。75例患者中，仅2例复发，中位随访时间31.7个月（范围：0至160个月）后均存活。Kaplan-Meier分析显示两组患者的总生存率（100.0%对100.0%）和无病生存率（90.0%对95.5%）无差异（P=0.579）。
保留卵巢对Ⅰa期、高分化子宫内膜癌年轻患者的生存无统计学显著影响。需要开展大规模、前瞻性临床研究来验证此类患者保留卵巢的安全性。
