Juhasz-Böss I, Fehm T, Becker S, Rothmund R, Krämer B, Staebler A, Wallwiener D, Solomayer E F
Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar.
Universitätsfrauenklinik Tübingen, Tübingen.
Geburtshilfe Frauenheilkd. 2012 Aug;72(8):721-726. doi: 10.1055/s-0032-1315206. Epub 2012 Aug 16.
The aim of our study was to investigate the rate of secondary carcinomas in patients with endometrial carcinoma (EC). In particular, we wanted to describe the subset of patients with endometrial and simultaneous ovarian carcinoma (OC), including outcomes. The study also compared patients with EC and ovarian metastasis with patients with EC and simultaneous OC. Data from 251 patients with primary endometrial carcinoma who underwent surgery in the years 2005-2009 at the Department of Obstetrics and Gynaecology, University of Tübingen, were analysed retrospectively. A total of 28 patients (11.1 %) had a secondary carcinoma: 18 patients (7.1 %) had OC; 9 (3.5 %) patients had a history of breast cancer, and one patient (0.4 %) respectively had simultaneous carcinoma of the vulva or bladder. 14 patients (5.5 %) had advanced stage EC with ovarian metastasis or, in one case, metastasis to the ovarian tube. Patients with ovarian metastasis had a mean age of 71.2 ± 9.2 years at primary diagnosis, making them significantly older compared to patients with EC and simultaneous OC (55.3 ± 11.8 years, p < 0.001). Moreover, patients with ovarian metastasis significantly more often had EC with a higher tumour grade (grade 1: 0, grade 2: 21.4 %, grade 3: 78.6 %) compared to patients with simultaneous EC and OC (grade 1: 11.1 %, grade 2: 77.8 %, grade 3: 11.1 %; p < 0.001). Almost one in 10 patients with EC had a secondary carcinoma. The most common secondary carcinoma was OC followed by breast cancer. This should be taken into account in the diagnosis and therapy of patients with EC. Patients with simultaneous EC and OC were significantly younger than patients with EC and ovarian metastasis. In addition, their tumour had better prognostic features: thus, the tumour grade of the EC was significantly lower. Overall, the prognosis for patients with synchronous EC and OC is better than that for patients with EC and ovarian metastasis.
我们研究的目的是调查子宫内膜癌（EC）患者的继发癌发生率。具体而言，我们想要描述子宫内膜癌合并同时性卵巢癌（OC）患者的亚组情况，包括其预后。该研究还比较了EC合并卵巢转移患者与EC合并同时性OC患者的情况。对2005年至2009年期间在图宾根大学妇产科接受手术的251例原发性子宫内膜癌患者的数据进行了回顾性分析。共有28例患者（11.1%）发生了继发癌：18例患者（7.1%）患有OC；9例（3.5%）患者有乳腺癌病史，1例患者（0.4%）分别患有同时性外阴癌或膀胱癌。14例患者（5.5%）患有晚期EC伴卵巢转移，或在1例中伴有输卵管转移。卵巢转移患者在初次诊断时的平均年龄为71.2±9.2岁，与EC合并同时性OC患者（55.3±11.8岁，p<0.001）相比，年龄显著更大。此外，与EC合并同时性OC患者相比，卵巢转移患者的EC肿瘤分级更高的情况更为常见（1级：0，2级：21.4%，3级：78.6%）（1级：11.1%，2级：77.8%，3级：11.1%；p<0.001）。几乎每10例EC患者中就有1例发生继发癌。最常见的继发癌是OC，其次是乳腺癌。这在EC患者的诊断和治疗中应予以考虑。EC合并同时性OC患者比EC合并卵巢转移患者显著年轻。此外，他们的肿瘤具有更好的预后特征：因此，EC的肿瘤分级显著更低。总体而言，EC合并同时性OC患者的预后优于EC合并卵巢转移患者。
