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[不同治疗方法对Ⅰ期子宫内膜癌的预后意义]

[Prognostic significance of different therapeutic procedures in stage I endometrial cancer].

作者信息

Köhler U, Bilek K, Rosenkranz M

机构信息

Klinik für Gynäkologie und Geburtshilfe, Bereichs Medizin der Karl-Marx-Universität Leipzig.

出版信息

Zentralbl Gynakol. 1987;109(22):1374-81.

PMID:3434011
Abstract

The prognostic importance of the different lines of therapeutic management are retrospectively reviewed from 230 patients who have been primarily operated on for endometrial carcinoma stage I (FIGO). The postoperative radiation therapy taking into consideration the prognostic significance of the tumour criteria (tumour type, degree of differentiation and extent of myometrial invasion) as well as the age and the general condition of the patient would largely be individualized. 56 (24%) patients has been operated on only. There were no significant prognostic differences for vaginal and abdominal hysterectomies with bilateral salpingo-oophorectomy. Extensive operative measures have been carried out seldom and could not yet be included in the evaluation. A simultaneous gestagen administration in 39 (17%) of the cases with invasively growing carcinomas (greater than 1/3 myometrial invasion), independent from the previous therapeutic regimen, is shown not to have improved the healing results. The favourable prognosis of women mostly with lower primary risk and operated on only as opposed to postoperatively radiated ones underlines the primary prognostic significance of morphological characteristics of the tumour although no definite conclusions can be derived from the concurrent effectivity of the adjuvant radiotherapy for early tumour stages. A postoperative radiation therapy, because of its late consequences which have been observed during tumour follow up, is indicated only in those cases with unfavourable prognostic criteria.

摘要

对230例接受过子宫内膜癌I期(国际妇产科联盟[FIGO])初次手术的患者进行回顾性分析,以评估不同治疗方案的预后重要性。术后放疗会根据肿瘤标准(肿瘤类型、分化程度和肌层浸润范围)以及患者年龄和一般状况进行个体化调整。56例(24%)患者仅接受了手术。单纯阴道子宫切除术和腹式子宫切除术加双侧输卵管卵巢切除术在预后方面无显著差异。广泛的手术措施很少实施,尚未纳入评估。39例(17%)浸润性生长癌(肌层浸润大于1/3)患者,无论之前的治疗方案如何,均同时给予孕激素治疗,结果显示并未改善治疗效果。与接受术后放疗的患者相比,大多数初始风险较低且仅接受手术治疗的女性预后良好,这突出了肿瘤形态学特征的首要预后意义,尽管对于早期肿瘤阶段辅助放疗的同时有效性尚无明确结论。由于在肿瘤随访期间观察到术后放疗有晚期影响,因此仅在预后标准不利的情况下才进行术后放疗。

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