Descamps P, Body G, Calais G, Moire C, Fignon A, Jourdain O, Le Floch O, Lansac J
Service de Gynécologie-Obstétrique, CHU Bretonneau, Tours.
J Gynecol Obstet Biol Reprod (Paris). 1995;24(8):794-801.
Surgical treatment for endometrial carcinomas stage I and II is radical hysterectomy. The role of lymphadenectomy (pelvic and paraaortic) is under discussion. From a retrospective study (multivariate analysis of 320 patients treated by radiosurgical association) and a review of the literature, the authors limit the indications of lymphadenectomy to stage I grade 1 or 2 tumours and without deep tumours invasion into the myometrium (in that case only 10% of pelvic nodes will be involved). Stage II patients or stage I with grade 3 and/or deep tumour invasion into the myometrium do not require lymphadenectomy as post-operative pelvic external beam irradiation will be performed in all cases. Para-aortic lymphadenectomy is not useful as it increases morbidity and the adjuvant treatment in case of lymph node involvement does not improve the survival rate.
子宫内膜癌I期和II期的手术治疗是根治性子宫切除术。淋巴结切除术（盆腔和腹主动脉旁）的作用仍在讨论中。通过一项回顾性研究（对320例接受放疗手术联合治疗的患者进行多变量分析）以及文献综述，作者将淋巴结切除术的指征限制为I期1级或2级肿瘤且肿瘤未深度浸润肌层（在这种情况下，只有10%的盆腔淋巴结会受累）。II期患者或I期3级和/或肿瘤深度浸润肌层的患者不需要进行淋巴结切除术，因为所有病例均会进行术后盆腔外照射。腹主动脉旁淋巴结切除术没有用处，因为它会增加发病率，而且淋巴结受累时的辅助治疗并不能提高生存率。
