Department of Obstetrics and Gynecology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.
J BUON. 2021 Jul-Aug;26(4):1320-1326.
To explore the clinical efficacy of hysteroscopic resection combined with megestrol acetate in the treatment of patients with early-stage endometrial cancer (EC) and its prognosis.
130 patients with early-stage EC were divided into two groups: MA group (hysteroscopic resection combined with megestrol acetate, n=65) and Control group (hysteroscopic resection alone, n=65). The clinical efficacy, serum carbohydrate antigen 125 (CA125) level and incidence of adverse reactions were compared between the two groups, and the patients' pregnancy status, pregnancy outcome, survival status and tumor recurrence were recorded through follow-up.
The curative effect was assessed in all patients after treatment. The overall response rate was 83.1% (54/65) and 65.2% (43/65), respectively, in MA group and Control group, which was significant better in MA group than that in Control group. After treatment, the serum CA125 levels markedly declined in both groups. The pregnancy rate in MA group was obviously higher than in Control group. The follow-up results revealed that the 5-year overall survival (OS) was 83.1% (54/65) and 81.5% (53/65) and the progression-free survival (PFS) was 76.9% (50/65) and 73.8% (48/65), respectively, in MA group and Control group.
Hysteroscopic resection combined with megestrol acetate has superior clinical efficacy to hysteroscopic resection alone in the treatment of patients with early-stage EC, which can greatly increase the success rate of pregnancy and reduce the serum CA125 level. However, thelong-term survival and PFS of patients had no significant differencesbetween the two treatment methods. Key words: hysteroscopic resection, megestrol acetate, endometrial cancer, early stage, curative effect.
探讨宫腔镜电切术联合醋酸甲地孕酮治疗早期子宫内膜癌（EC）的临床疗效及其预后。
将 130 例早期 EC 患者分为两组：MA 组（宫腔镜电切术联合醋酸甲地孕酮，n=65）和对照组（宫腔镜电切术单独治疗，n=65）。比较两组患者的临床疗效、血清糖类抗原 125（CA125）水平及不良反应发生率，并通过随访记录患者的妊娠状况、妊娠结局、生存状况及肿瘤复发情况。
所有患者治疗后均进行疗效评估。MA 组和对照组的总有效率分别为 83.1%（54/65）和 65.2%（43/65），MA 组明显优于对照组。治疗后，两组患者血清 CA125 水平均明显下降。MA 组的妊娠率明显高于对照组。随访结果显示，MA 组的 5 年总生存率（OS）为 83.1%（54/65），无进展生存率（PFS）为 76.9%（50/65）；对照组的 5 年 OS 为 81.5%（53/65），PFS 为 73.8%（48/65）。
宫腔镜电切术联合醋酸甲地孕酮治疗早期 EC 的临床疗效优于单纯宫腔镜电切术，能显著提高妊娠成功率，降低血清 CA125 水平，但两种治疗方法对患者的长期生存和 PFS 无显著影响。关键词：宫腔镜电切术；醋酸甲地孕酮；子宫内膜癌；早期；疗效。
