Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand.
Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Asian Pac J Cancer Prev. 2024 Jan 1;25(1):95-101. doi: 10.31557/APJCP.2024.25.1.95.
Endometrial cancer (EC) is the most common gynecological cancer in developed countries and a standard treatment of surgery should be performed as expediently as possible. Delay time to surgery and survival was debated. The aim of this investigation was to evaluate the effect of time-interval between diagnosis and surgery (TDS) in EC patients with regards to prognosis and mortality rates.
This retrospective study was conducted between January 2009 and May 2021 at Bhumibol Adulyadej Hospital, Thailand. Subjects were EC cases who underwent primary surgery during the study period. Cases with partial treatment were disqualified from the study. Subjects who underwent surgery before and after 6 weeks were classified as early and delayed surgery groups. Baseline and clinical characteristics were collected and analyzed.
During the study period, 419 EC cases were recruited. The mean age of participants was 56.8 years. Two-thirds (338/491) of subjects were menopausal. Endometrioid histology (406/491) was the most common histology subtype. Five years disease free survival (DFS) of early and delayed surgery groups were comparable at a percentage of 82.5 and 83.0, respectively. Among advanced stage and non-endometrioid EC cases, the delayed surgery group had significantly shorter DFS than the early group. Advanced stage, high grade and positive lympho-vascular space invasion (LVSI) were independent factors for poor DFS. Predictive factors for mortality were advanced stage and tumor recurrence.
The TDS was not a prognostic factor for disease recurrence or overall mortality. Time to surgery equal to or more than 6 weeks gave worse prognosis for DFS among advanced stage or non-endometrioid histology EC.
子宫内膜癌（EC）是发达国家最常见的妇科癌症，应尽快进行手术标准治疗。手术时间延迟与生存时间存在争议。本研究旨在评估 EC 患者诊断与手术之间的时间间隔（TDS）对预后和死亡率的影响。
本回顾性研究于 2009 年 1 月至 2021 年 5 月在泰国的 Bhumibol Adulyadej 医院进行。研究对象为在研究期间接受初次手术的 EC 病例。部分治疗的病例被排除在研究之外。将手术时间在 6 周之前和之后的病例分为早期手术组和延迟手术组。收集并分析基线和临床特征。
在研究期间，共纳入了 419 例 EC 病例。参与者的平均年龄为 56.8 岁。三分之二（338/491）的患者处于绝经后状态。最常见的组织学亚型是子宫内膜样组织学（406/491）。早期手术组和延迟手术组的 5 年无病生存率（DFS）分别为 82.5%和 83.0%，差异无统计学意义。在晚期和非子宫内膜样 EC 病例中，延迟手术组的 DFS 明显短于早期手术组。晚期、高级别和阳性淋巴管血管间隙浸润（LVSI）是 DFS 不良的独立因素。死亡的预测因素是晚期和肿瘤复发。
TDS 不是疾病复发或总死亡率的预后因素。对于晚期或非子宫内膜样组织学 EC 患者，手术时间等于或超过 6 周会导致 DFS 预后较差。
