子宫内膜癌的手术治疗与生育功能保留
Surgical treatment and fertility perservation in endometrial cancer.
作者信息
Kovacevic Nina
机构信息
Department of Gynaecological Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
出版信息
Radiol Oncol. 2021 Feb 11;55(2):144-149. doi: 10.2478/raon-2021-0009.
BACKGROUND
Endometrial cancer (EC) represents a high health burden in Slovenia and worldwide. The incidence is increasing due to lifestyle and behavioural risk factors such as obesity, smoking, oestrogen exposure and aging of the population. In many cases, endometrial cancer is diagnosed at an early stage due to obvious signs and symptoms. The standard treatment is surgery with or without adjuvant therapy, depending on the stage of the disease and the risk of recurrence. However, treatment modalities have changed in the last decades, considerably in the extent of lymphadenectomy.
CONCLUSIONS
The gold standard of treatment for is surgery, which may be the only treatment modality in the early stages of low-grade tumours. In recent years, a minimally invasive approach with sentinel node biopsy (SNB) has been proposed. A conservative approach with hormonal treatment is used if fertility preservation is desired. If EC is in advance stage, high-risk histology, or high grade, radiotherapy, chemotherapy, or a combination of both is recommended.
背景
子宫内膜癌（EC）在斯洛文尼亚乃至全球都构成了沉重的健康负担。由于肥胖、吸烟、雌激素暴露和人口老龄化等生活方式和行为风险因素，其发病率正在上升。在许多情况下，由于明显的体征和症状，子宫内膜癌在早期就被诊断出来。标准治疗方法是根据疾病阶段和复发风险进行手术，可辅以或不辅以辅助治疗。然而，在过去几十年中，治疗方式发生了变化，尤其是在淋巴结清扫范围方面。
结论
治疗的金标准是手术，这可能是低级别肿瘤早期的唯一治疗方式。近年来，有人提出了采用前哨淋巴结活检（SNB）的微创方法。如果希望保留生育能力，则采用激素治疗的保守方法。如果子宫内膜癌处于晚期、具有高危组织学特征或高级别，则建议进行放疗、化疗或两者联合治疗。
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