Takeshima N, Umezawa S, Yamawaki T, Shimizu Y, Hirai Y, Chen J T, Yamauchi K, Hasumi K
Department of Gynecology, Cancer Institute Hospital, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1995 Jun;47(6):553-8.
Between 1974 and 1991, 621 patients with endometrial cancer were treated with hysterectomy without any preoperative treatment. Subsequent pathological examinations revealed that 92 cases had no myometrial invasion. Clinicopathological analysis was carried out in the 92 patients. The results are as follows: 1. Complete surgery was carried out in all cases except one case with intraperitoneal dissemination. The relapse rate in the 91 cases was 2.2% (2/91). The 2 cases with recurrence had grade 1 (G1) and grade 2 (G2) adenocarcinoma and both cases manifested local recurrence. 2. Of 70 cases treated with pelvic lymphadenectomy, two cases (2.9%) with G1 adenocarcinoma exhibited a single node metastasis. The metastatic site was an external iliac lymph node in both cases. Despite the lymph node metastasis, the 2 cases have exhibited no relapse. 3. None of the 92 cases showed any evidence of adnexal metastasis. The positive rate of peritoneal cytology was 13.4% (9/67). Except for one case with peritoneal dissemination who also had positive peritoneal cytology, 8 cases with positive peritoneal cytology have not developed recurrence. This study showed that some endometrial cancer patients without myometrial invasion manifest recurrence, peritoneal dissemination or lymph node metastasis. It is therefore considered that lymphadenectomy and careful follow-up are necessary in every case of endometrial cancer, even in G1 cases without myometrial invasion.
1974年至1991年间，621例子宫内膜癌患者接受了子宫切除术，术前未进行任何治疗。随后的病理检查显示，92例患者没有肌层浸润。对这92例患者进行了临床病理分析。结果如下：1. 除1例有腹腔播散的患者外，所有病例均进行了根治性手术。91例患者的复发率为2.2%（2/91）。2例复发患者分别为1级（G1）和2级（G2）腺癌，均表现为局部复发。2. 在70例行盆腔淋巴结清扫术的患者中，2例（2.9%）G1腺癌患者出现单个淋巴结转移。转移部位均为髂外淋巴结。尽管有淋巴结转移，但这2例患者均未复发。3. 92例患者均未显示附件转移的任何证据。腹腔细胞学检查阳性率为13.4%（9/67）。除1例有腹腔播散且腹腔细胞学检查也为阳性的患者外，8例腹腔细胞学检查阳性的患者均未复发。本研究表明，一些无肌层浸润的子宫内膜癌患者会出现复发、腹腔播散或淋巴结转移。因此，即使是无肌层浸润的G1期病例，每例子宫内膜癌患者都有必要进行淋巴结清扫术并进行仔细随访。
