Li Yi, Yang Dong, Yang Shuangjian
The First Affiliated Hospital, Department of Obstetrics and Gynecology, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
The First Affiliated Hospital, Department of Radiation Oncology, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
Evid Based Complement Alternat Med. 2021 Oct 18;2021:8793187. doi: 10.1155/2021/8793187. eCollection 2021.
Recurrence of endometrial cancer after initial treatment can be complex and difficult to treat. The current main treatment modalities for patients with recurrent endometrial cancer (REC) include chemotherapy, radiotherapy, and surgery, which vary according to the individual patient. However, REC is often associated with a poor prognosis, and it is therefore important to investigate the risk factors affecting REC prognosis and to explore appropriate treatment modalities to improve the prognosis and treatment strategies for patients with REC.
Totally, 100 patients with REC admitted to our hospital from January 2013 to January 2018 were chosen to be research objects. Their pathological data were analyzed, including age, disease-free interval (DFI), recurrence site, and treatment plan after relapse (definitive local therapy (DLT) and palliative chemotherapy (PC)). According to these parameters, univariate and multivariate factors affecting the prognosis of REC patients and the curative effect of PC were analyzed, and the 3-year overall survival (OS) curve and progression-free survival (PFS) curve were drawn.
After 3 years of follow-up, 30 patients had a poor prognosis and 70 had a good prognosis, according to which a single multifactorial analysis was performed for different prognoses, where the results of the single-factor analysis showed significant differences between patients with different prognoses in terms of pathomorphology, pathological grading, TFI, and treatment modality after relapse. Further multifactorial analysis showed that TFI and treatment modality after recurrence were independent factors affecting poor prognosis in REC patients. The 3-year OS and 3-year PFS of REC patients were 74.00% and 70.00%, respectively. Patients whose DFI was less than 12 months or treated with PC after relapse were notably associated with lower levels of 3-year OS and 3-year PFS. In addition, radiotherapy and chemotherapy, DFI, and chemotherapy plan after primary surgery were independent risk factors that affected the PC efficacy of REC patients.
DFI and treatment mode after relapse are independent factors affecting the prognosis of REC patients. DLT can obviously improve the prognosis of REC patients. For patients who can only choose PC, chemoradiotherapy and DFI after primary surgery are helpful to predict the chemotherapy effect, and the combination of paclitaxel and platinum drugs should be the first choice for chemotherapy.
子宫内膜癌初次治疗后的复发情况可能较为复杂且难以治疗。复发性子宫内膜癌（REC）患者目前的主要治疗方式包括化疗、放疗和手术，具体治疗方式因人而异。然而，REC通常预后较差，因此，研究影响REC预后的危险因素并探索合适的治疗方式以改善REC患者的预后及治疗策略具有重要意义。
选取2013年1月至2018年1月我院收治的100例REC患者作为研究对象。对其病理资料进行分析，包括年龄、无病间期（DFI）、复发部位以及复发后的治疗方案（确定性局部治疗（DLT）和姑息化疗（PC））。根据这些参数，分析影响REC患者预后及PC疗效的单因素和多因素，绘制3年总生存（OS）曲线和无进展生存（PFS）曲线。
随访3年后，30例患者预后较差，70例患者预后良好，据此对不同预后进行单因素多因素分析，单因素分析结果显示，不同预后患者在病理形态学、病理分级、TFI及复发后的治疗方式方面存在显著差异。进一步多因素分析显示，TFI及复发后的治疗方式是影响REC患者预后不良的独立因素。REC患者的3年OS率和3年PFS率分别为74.00%和70.00%。DFI小于12个月或复发后接受PC治疗的患者，其3年OS率和3年PFS率明显较低。此外，放疗和化疗、DFI以及初次手术后的化疗方案是影响REC患者PC疗效的独立危险因素。
DFI及复发后的治疗模式是影响REC患者预后的独立因素。DLT可明显改善REC患者的预后。对于只能选择PC的患者，初次手术后的放化疗及DFI有助于预测化疗效果，化疗首选紫杉醇与铂类药物联合。
