Yin Hongmei, Gui Ting
Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou Medical University, Binzhou, Shandong, People's Republic of China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Onco Targets Ther. 2016 Feb 16;9:781-6. doi: 10.2147/OTT.S95806. eCollection 2016.
To investigate the impact of surgical resection extent on the postoperative complications and the prognosis in patients with stage II endometrial cancer.
A total of 54 patients were retrospectively reviewed, 35 patients underwent subradical hysterectomy and 19 patients received radical hysterectomy, both with simultaneous bilateral salpingo-oophorectomy and pelvic and paraaortic lymphadenectomy.
Comparing the surgical outcomes in subradical hysterectomy group vs radical hysterectomy group, there were no significant differences in operative time, estimated blood loss, and hospital stay. After surgery, 37.1% vs 36.8% patients received postoperative radiotherapy in the subradical hysterectomy group vs radical hysterectomy group, without statistically significant difference. As for postoperative complications, the early postoperative complication rate in patients who underwent subradical hysterectomy was 14.3%, significantly lower than that in patients submitted to radical hysterectomy (14.3% vs 42.1%), with P=0.043. However, there was no significant difference in late postoperative complication rate between the two surgical procedures. Regarding the clinical prognosis, patients receiving the subradical hysterectomy showed similar survival to their counterparts undergoing the radical procedures. The relapse rate was 5.71% vs 5.26%, respectively, without significant difference. There were no deaths in both surgical groups.
For stage II endometrial carcinoma, subradical hysterectomy presented with less early postoperative complications and similar survival duration and recurrence compared with radical hysterectomy and should be advocated in clinical treatment.
探讨手术切除范围对Ⅱ期子宫内膜癌患者术后并发症及预后的影响。
回顾性分析54例患者，35例行次广泛子宫切除术，19例行根治性子宫切除术，均同时行双侧输卵管卵巢切除术及盆腔和腹主动脉旁淋巴结清扫术。
比较次广泛子宫切除术组与根治性子宫切除术组的手术结果，手术时间、估计失血量和住院时间无显著差异。术后，次广泛子宫切除术组与根治性子宫切除术组分别有37.1%和36.8%的患者接受术后放疗，无统计学差异。至于术后并发症，行次广泛子宫切除术患者的早期术后并发症发生率为14.3%，显著低于行根治性子宫切除术的患者（14.3%对42.1%），P = 0.043。然而，两种手术方式的晚期术后并发症发生率无显著差异。关于临床预后，接受次广泛子宫切除术的患者与接受根治性手术的患者生存率相似。复发率分别为5.71%和5.26%，无显著差异。两组均无死亡病例。
对于Ⅱ期子宫内膜癌，次广泛子宫切除术与根治性子宫切除术相比，术后早期并发症较少，生存时间和复发情况相似，临床治疗中应予以提倡。
