Schmidt Ana-Maria, Imesch Patrick, Fink Daniel, Egger Herwig
*Department of Gynecology, University Hospital Zurich, Zurich, Switzerland; and †Department of Obstetrics and Gynecology, General Hospital Neumarkt, Germany.
Int J Gynecol Cancer. 2016 May;26(4):716-21. doi: 10.1097/IGC.0000000000000678.
The aim of this study was to analyze the clinical experience and outcome of patients who have undergone pelvic exenteration for primary advanced or recurrent endometrial cancer.
We analyzed the medical records of 40 women who underwent pelvic exenteration to treat primary advanced or recurrent endometrial cancer.
Pelvic exenteration was performed in 40 patients with primary advanced or recurrent endometrial cancer. Three patients (8%) underwent a primary exenteration, and 37 patients (92%) underwent a secondary exenteration. A total exenteration, anterior exenteration, and posterior exenteration was performed in 85%, 5%, and 10% of patients, respectively.In 31 cases, exenteration was performed with a curative aim, and in 9 cases, exenteration was performed with a palliative aim. The overall survival rates were 61.4% at 5 years and 51.1% at 10 years. For the 31 patients who underwent pelvic exenteration with a curative aim, the overall survival rates were higher than those for the entire study population and were 72.6% at 5 years and 59.4% at 10 years. For the 9 patients who underwent a palliative exenteration, the overall survival rates were 19.1% at 5 years and 0% at 10 years. This is to the best of our knowledge the biggest study of pelvic exenteration in patients with endometrial cancer.
Our data show that pelvic exenterations are a valid therapeutic option with long-term survival in select patients.
本研究旨在分析因原发性晚期或复发性子宫内膜癌接受盆腔脏器清除术患者的临床经验及治疗结果。
我们分析了40例因原发性晚期或复发性子宫内膜癌接受盆腔脏器清除术的女性患者的病历。
40例原发性晚期或复发性子宫内膜癌患者接受了盆腔脏器清除术。3例（8%）患者接受了初次盆腔脏器清除术，37例（92%）患者接受了二次盆腔脏器清除术。分别有85%、5%和10%的患者接受了全盆腔脏器清除术、前盆腔脏器清除术和后盆腔脏器清除术。31例手术目的为根治性，9例手术目的为姑息性。总体5年生存率为61.4%，10年生存率为51.1%。对于31例接受根治性盆腔脏器清除术的患者，其总体生存率高于整个研究人群，5年生存率为72.6%，10年生存率为59.4%。对于9例接受姑息性盆腔脏器清除术的患者，5年生存率为19.1%，10年生存率为0%。据我们所知，这是关于子宫内膜癌患者盆腔脏器清除术的最大规模研究。
我们的数据表明，盆腔脏器清除术对于部分患者而言是一种有效的治疗选择，可实现长期生存。
