Piana L, Boubli L, Boyer A, Bouclier S, Jacqueme B, Conte M
J Gynecol Obstet Biol Reprod (Paris). 1986;15(3):347-54.
Having seen 192 cases of cancer of the endometrium treated at the Institute Paoli-Calmettes between the years 1975 and 1980, the authors have been able to evaluate the place of surgery in the planning of treatment of Stage I and II cases. They hold that: Laparatomy is well tolerated, in 90% of cases of Stage I, 88% of cases of Stage II, 70% of older than 70 years of age and 79% of patients who have some wasting there was no operative mortality. The need to re-explore Stage I and Stage II cases surgically (14%) especially when invasion of the ovaries had not been recognized before histological examination exists. The bad influence of the 5 year survival rate of histological grade 3 or where the myometrium was deeply invaded or where the pelvic lymph nodes were invaded. Studying this personal series and other series found is the literature shows that there is no great value in clearing the pelvis of lymph nodes in order to plan the post-surgical treatment. This is because generally lymph node involvement in the pelvis is associated with other factors that are unfavourable prognostically and these factors can be determined more easily than by removing the lymph nodes. They are, grade 3, invasion of the cervix, positive peritoneal cytology and when the myometrium has been invaded more than 50%. It was only in two cases out of 122 that study of the lymph nodes of the pelvis altered the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
作者回顾了1975年至1980年间在保利-卡尔梅特研究所接受治疗的192例子宫内膜癌病例，从而能够评估手术在I期和II期病例治疗规划中的地位。他们认为：剖腹术耐受性良好，在I期病例中有90%、II期病例中有88%、70岁以上患者中有70%以及有消瘦情况的患者中有79%没有手术死亡率。对于I期和II期病例，存在手术再次探查的必要性（14%），特别是在组织学检查前未识别出卵巢受侵的情况下。组织学3级、肌层深度受侵或盆腔淋巴结受侵对5年生存率有不良影响。研究该个人病例系列以及文献中发现的其他系列表明，为规划术后治疗而清扫盆腔淋巴结没有太大价值。这是因为一般来说，盆腔淋巴结受累与其他预后不良的因素相关，而且这些因素比通过切除淋巴结更容易确定。这些因素包括3级、宫颈受侵、腹膜细胞学阳性以及肌层受侵超过50%。在122例病例中，只有2例盆腔淋巴结检查改变了治疗方案。（摘要截选至250词）
