探讨了患有腹主动脉淋巴结转移的子宫内膜癌患者的治疗效果：一项多机构分析。

Treatment outcomes of endometrial cancer patients with paraaortic lymph node metastasis: a multi-institutional analysis.

机构信息

Department of Radiation Oncology, Başkent University Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Adana, Turkey

Department of Radiation Oncology, Başkent University Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Adana, Turkey.

出版信息

Int J Gynecol Cancer. 2019 Jan;29(1):94-101. doi: 10.1136/ijgc-2018-000029.

DOI:10.1136/ijgc-2018-000029

PMID:30640689

Abstract

OBJECTIVE

To analyze the prognostic factors and treatment outcomes in endometrial cancer patients with paraaortic lymph node metastasis.

METHODS

Data from four centers were collected retrospectively for 92 patients with endometrial cancer treated with combined radiotherapy and chemotherapy or adjuvant radiotherapy alone postoperatively, delivered by either the sandwich or sequential method. Prognostic factors affecting overall survival and progression-free survival were analyzed.

RESULTS

The 5-year overall survival and progression-free survival rates were 35 % and 33 %, respectively, after a median follow-up time of 33 months. The 5-year overall survival and progression-free survival rates were significantly higher in patients receiving radiotherapy and chemotherapy postoperatively compared with patients treated with adjuvant radiotherapy alone (P < 0.001 and P < 0.001, respectively). In a subgroup analysis of patients treated with adjuvant combined chemotherapy and radiotherapy, the 5-year overall survival and progression-free survival rates were significantly higher in patients receiving chemotherapy and radiotherapy via the sandwich method compared with patients treated with sequential chemotherapy and radiotherapy (P = 0.02 and P = 0.03, respectively). In the univariate analysis, in addition to treatment strategy, pathology, depth of myometrial invasion, and tumor grade were significant prognostic factors for both overall survival and progression-free survival. In the multivariate analysis, grade III disease, myometrial invasion greater than or equal to 50%, and adjuvant radiotherapy alone were negative predictors for both overall survival and progression-free survival.

CONCLUSION

We demonstrated that adjuvant combined treatment including radiotherapyand chemotherapy significantly increases overall survival and progression-free survival rates compared with postoperative pelvic and paraaortic radiotherapy.

摘要

目的

分析有腹主动脉淋巴结转移的子宫内膜癌患者的预后因素和治疗结果。

方法

回顾性收集了 4 个中心的 92 例子宫内膜癌患者的数据，这些患者在术后接受了联合放化疗或辅助放疗，采用三明治或序贯法进行。分析了影响总生存率和无进展生存率的预后因素。

结果

中位随访时间为 33 个月后，总生存率和无进展生存率分别为 35%和 33%。术后接受放化疗的患者的 5 年总生存率和无进展生存率明显高于仅接受辅助放疗的患者（P<0.001 和 P<0.001）。在接受辅助联合化疗和放疗的患者亚组分析中，接受三明治法化疗和放疗的患者的 5 年总生存率和无进展生存率明显高于接受序贯化疗和放疗的患者（P=0.02 和 P=0.03）。单因素分析除了治疗策略外，病理、肌层浸润深度和肿瘤分级也是总生存率和无进展生存率的显著预后因素。多因素分析显示，III 级疾病、肌层浸润大于或等于 50%以及辅助放疗是总生存率和无进展生存率的负性预测因素。