Chen S S
Gynecol Oncol. 1985 May;21(1):23-31. doi: 10.1016/0090-8258(85)90228-8.
From July 1975 to April 1983, 237 patients had primary treatment for endometrial cancer at the Long Island Jewish-Hillside Medical Center. Included in this study were 74 of these patients with Stage I and 20 with Stage II endometrial carcinoma who underwent laparotomy without preoperative radiation. The purpose of the study was to determine the prevalence of extrauterine spread in endometrial carcinoma clinically confined to the uterus and to correlate risk variables with this spread. The parameters assessed were retroperitoneal nodal metastases, adnexal involvement, peritoneal implants and peritoneal cytology. The overall prevalence of extrauterine spread was 23.4% (Stage I, 18.9%; Stage II, 40.0%). The rate of nodal metastasis, adnexal involvement, peritoneal implant, and positive peritoneal cytology were 18.7, 7.4, 4.3, and 8.5%, respectively. No positive relationship was demonstrated between surface spread and risk variables. There was positive correlation between surface spread and peritoneal cytology (87.5%). Direct correlations were found between positive nodes and tumor growth over more than one-third of the endometrial surface (P less than 0.001), gross cervical involvement (P less than 0.001), deep myometrial invasion (p less than 0.001), length of uterine cavity, grade 3 tumor, papillary adenocarcinoma (40%), and stage of disease. Five-year survival rate of Stage I and Stage II in this small series was 77.8 and 55.6%. Complications of 16 radical hysterectomies in Stage II were minimal and transient. Because of frequent extrauterine spread in endometrial carcinoma clinically confined to the uterus, and exploratory laparotomy and peritoneal cytology may be desirable in Stage I and II disease before definitive treatment.
1975年7月至1983年4月，237例患者在长岛犹太山边医疗中心接受子宫内膜癌的初始治疗。本研究纳入了其中74例I期和20例II期子宫内膜癌患者，这些患者接受了剖腹手术且未进行术前放疗。本研究的目的是确定临床局限于子宫的子宫内膜癌宫外播散的发生率，并将风险变量与此种播散相关联。评估的参数包括腹膜后淋巴结转移、附件受累、腹膜种植和腹膜细胞学检查。宫外播散的总体发生率为23.4%（I期为18.9%；II期为40.0%）。淋巴结转移率、附件受累率、腹膜种植率和腹膜细胞学阳性率分别为18.7%、7.4%、4.3%和8.5%。未发现表面播散与风险变量之间存在正相关关系。表面播散与腹膜细胞学检查之间存在正相关（87.5%）。发现阳性淋巴结与超过三分之一子宫内膜表面的肿瘤生长（P<0.001）、宫颈大体受累（P<0.001）、肌层深部浸润（P<0.001）、子宫腔长度、3级肿瘤、乳头状腺癌（40%）及疾病分期之间存在直接相关性。在这个小样本系列中，I期和II期的5年生存率分别为77.8%和55.6%。II期16例根治性子宫切除术的并发症轻微且短暂。由于临床局限于子宫的子宫内膜癌常发生宫外播散，对于I期和II期疾病，在确定性治疗前进行剖腹探查和腹膜细胞学检查可能是可取的。
