National Cancer Institute, Kyiv 03022, Ukraine.
R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences of Ukraine, Kyiv 03022, Ukraine.
Exp Oncol. 2021 Dec;43(4):365-369. doi: 10.32471/exp-oncology.2312-8852.vol-43-no-4.17052.
The aim of this study was to determine the rates of recurrences of stage I endometrial cancer (EC) and features of their localization depending on the clinical and pathological characteristics of the tumor and methods of patients' treatment.
The study included 968 patients with stage I endometrioid EC, who underwent surgical treatment in the Department of Oncogynecology of the National Cancer Institute in 2015-2019. Surveillance of patients lasted from January 2015 to December 2020, with a minimum follow-up period of 1 year from the date of surgery. Adjuvant radiation or chemotherapy was performed depending on the clinical and pathological characteristics of the EC case.
During the follow-up period, recurrences were observed in 7.0% of cases and were most often found in stage IC of low differentiation grade. It was found that during surgical treatment without adjuvant therapy relapses occurred in 12-36 months after the start of treatment, with adjuvant radiation therapy - in 6-18 months, and with adjuvant chemotherapy - in 32-60 months. Recurrences most often occurred in patients with EC who underwent surgical treatment in combination with chemotherapy (p < 0.05). The lowest number of recurrences was recorded among patients who underwent surgery as an only treatment. The best 5-year survival rate was observed in the group of patients with surgical treatment (93%), and the worst - in the patients treated with combination of surgery and chemotherapy (57%). In patients without recurrences, the survival rate after treatment was 97%, while in patients diagnosed with relapses, the survival rate was 65%.
Despite the predominantly favorable course of EC stage I, some patients develop relapses. The rate and localization of recurrences depend on the histological structure of the tumor and treatment regimens of the EC patients.
本研究旨在确定 I 期子宫内膜癌(EC)的复发率及其定位特征,这些特征取决于肿瘤的临床和病理特征以及患者的治疗方法。
本研究纳入了 2015 年至 2019 年在国家癌症研究所妇科肿瘤学系接受手术治疗的 968 例 I 期子宫内膜样 EC 患者。对患者的随访时间从 2015 年 1 月至 2020 年 12 月,自手术之日起的最小随访时间为 1 年。根据 EC 病例的临床和病理特征,对患者进行辅助放疗或化疗。
在随访期间,7.0%的病例出现复发,且复发最常见于低分化分级的 IC 期。研究发现,在无辅助治疗的手术治疗中,复发发生在治疗开始后 12-36 个月,辅助放疗发生在 6-18 个月,辅助化疗发生在 32-60 个月。在接受手术联合化疗治疗的 EC 患者中,复发最为常见(p<0.05)。仅接受手术治疗的患者中,复发的数量最少。仅接受手术治疗的患者 5 年生存率最佳(93%),而接受手术联合化疗治疗的患者最差(57%)。在无复发的患者中,治疗后的生存率为 97%,而在诊断为复发的患者中,生存率为 65%。
尽管 I 期 EC 的病程主要良好,但部分患者仍会出现复发。复发的发生率和定位取决于肿瘤的组织学结构和 EC 患者的治疗方案。