Wang Ding-Ran
Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing 100191, China.
World J Clin Cases. 2023 Aug 16;11(23):5447-5454. doi: 10.12998/wjcc.v11.i23.5447.
Endometrial cancer is one of the most commonly diagnosed gynecological cancers worldwide, and early-stage high-risk endometrial cancer has a poor prognosis. Adjuvant treatments after surgery, such as chemotherapy and radiotherapy, have been widely used in clinical practice to improve patient survival. Medroxyprogesterone acetate is a synthetic progestogen that has been reported to have potential anticancer effects in endometrial cancer. However, its efficacy, safety, and long-term prognostic benefits as an adjuvant treatment for endometrial cancer remain controversial. Therefore, this study aimed to observe the efficacy and prognostic impact of adjuvant medroxyprogesterone acetate treatment in patients with early-stage high-risk endometrial cancer and evaluate its safety.
To observe the efficacy and prognosis of adjuvant treatment of endometrial cancer with medroxyprogesterone acetate and to evaluate its safety.
We collected the clinical data of 200 patients with early-stage high-risk endometrial cancer who were admitted to the Department of Obstetrics and Gynecology of our hospital from January 2018 to December 2022. The control group (100 patients) underwent conventional surgical treatment, and the study group (100 patients) was administered adjuvant medroxyprogesterone acetate tablets on top of the control group. The Kaplan-Meier curve analysis and log-rank test were performed to determine the possible factors influencing the 5-year cumulative survival rate in the patients. The Cox regression analysis was performed to identify the factors influencing the survival prognosis of endometrial cancer.
According to the Cox regression analysis, age [hazard ratio (HR) = 4.636, 95% confidence interval (95%CI): 1.411-15.237], pathological type (HR = 6.943, 95%CI: 2.299-20.977), molecular typing (HR = 5.789, 95%CI: 3.305-10.141), and myometrial infiltration (HR = 5.768, 95%CI: 1.898-17.520) were factors influencing the prognosis of patients with early-stage high-risk endometrial cancer.
Age, pathological type, molecular typing, and myometrial infiltration were all relevant factors affecting the prognosis of early-stage high-risk endometrial cancer. The potential long-term prognostic benefit of adjuvant postoperative radiotherapy in patients with early-stage high-risk endometrial cancer is worthy of clinical consideration.
子宫内膜癌是全球最常见的妇科癌症之一，早期高危子宫内膜癌预后较差。手术后的辅助治疗，如化疗和放疗，已在临床实践中广泛应用以提高患者生存率。醋酸甲羟孕酮是一种合成孕激素，据报道在子宫内膜癌中具有潜在的抗癌作用。然而，其作为子宫内膜癌辅助治疗的疗效、安全性和长期预后益处仍存在争议。因此，本研究旨在观察醋酸甲羟孕酮辅助治疗对早期高危子宫内膜癌患者的疗效和预后影响，并评估其安全性。
观察醋酸甲羟孕酮辅助治疗子宫内膜癌的疗效和预后，并评估其安全性。
收集2018年1月至2022年12月在我院妇产科住院的200例早期高危子宫内膜癌患者的临床资料。对照组（100例患者）接受常规手术治疗，研究组（100例患者）在对照组基础上加用醋酸甲羟孕酮片进行辅助治疗。采用Kaplan-Meier曲线分析和对数秩检验确定影响患者5年累积生存率的可能因素。进行Cox回归分析以确定影响子宫内膜癌生存预后的因素。
根据Cox回归分析，年龄[风险比（HR）=4.636，95%置信区间（95%CI）：1.411 - 15.237]、病理类型（HR = 6.943，95%CI：2.299 - 20.977）、分子分型（HR = 5.789，95%CI：3.305 - 10.141）和肌层浸润（HR = 5.768，95%CI：1.898 - 17.520）是影响早期高危子宫内膜癌患者预后的因素。
年龄、病理类型、分子分型和肌层浸润均是影响早期高危子宫内膜癌预后的相关因素。早期高危子宫内膜癌患者术后辅助放疗潜在的长期预后益处值得临床考虑。
