Low-risk corpus cancer: Is lymphadenectomy or radiotherapy necessary?
Low-risk corpus cancer: Is lymphadenectomy or radiotherapy necessary?
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DOI：
10.1067/mob.2000.107335
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发表时间：
2000-06-01
影响因子：
9.8
通讯作者：
Podratz, KC
中科院分区：
文献类型：
--
作者：
Mariani, A;Webb, MJ;Podratz, KC
目的：本研究的目的是寻找易于确定的术中病理指标，以区分不需要淋巴结切除术或辅助放疗的早期体癌亚组。1984年至1993年间，共有328例子宫内膜样体癌患者，1级或2级肿瘤，子宫肌层浸润小于或等于50%，术中无肉眼可见的宫外扩散迹象。187例（57%）行盆腔淋巴结清扫术，9例（5%）淋巴结阳性。65例患者（20%）接受了辅助放疗。中位随访时间为88个月。结果：5年总的癌症相关生存率和无复发生存率分别为97%和96%。原发肿瘤直径和淋巴管或血管浸润显着影响寿命。结论：国际妇产科联合会1 ~ 2级子宫体样癌，最大表面直径≤ 2cm，肌层浸润≤ 50%，术中无肉眼可见病变的患者，可选择单纯子宫切除术。
OBJECTIVE: The objective of this study was to find readily ascertainable intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy or adjuvant radiotherapy.STUDY DESIGN: Between 1984 and 1993, a total of 328 patients with endometrioid corpus cancer, grade 1 or 2 tumor, myometrial invasion less than or equal to 50%, and no intraoperative evidence of macroscopic extrauterine spread were treated surgically. Pelvic lymphadenectomy was performed in 187 cases (57%), and nodes were positive in nine cases (5%). Adjuvant radiotherapy was administered to 65 patients (20%). Median follow-up was 88 months.RESULTS: The 5-year overall cancer-related and recurrence-free survivals were 97% and 96%, respectively. Primary tumor diameter and lymphatic or vascular invasion significantly affected longevity. No patient with tumor diameter less than or equal to 2 cm had positive lymph nodes or died of disease.CONCLUSION: Patients who have International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid corpus cancer with greatest surface dimension less than or equal to 2 cm, myometrial invasion less than or equal to 50%, and no intraoperative evidence of macroscopic disease can be treated optimally with hysterectomy only.