Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan
Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan
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因子宫内膜癌而接受子宫切除术的老年患者的肿瘤学结果：日本近畿地区的多机构调查
DOI：
10.1007/s10147-022-02152-6
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发表时间：
2022
影响因子：
3.3
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Tanaka Tomohito;Matsumura Noriomi;et al.
本研究的目的是通过三个变量来评估接受子宫切除术的老年子宫内膜癌患者的肿瘤预后：子宫切除术入路、淋巴结切除术和辅助治疗。方法收集19所医院年龄≥70岁因子宫内膜癌行子宫切除术患者的住院记录。患者被分为三个风险组：低、中、高。各组患者根据子宫切除入路、淋巴结切除及Kaplan-Meier法辅助治疗比较无病生存期和总生存期。采用95%置信区间的Cox回归分析估计相对死亡风险（RR）。结果共纳入1246例患者。在低危组，微创手术（MIS）与开腹手术、淋巴结切除与不切除淋巴结的校正RR分别为0.64（0.24-1.72）和0.52（0.24-1.12）。在中危组中，MIS与剖腹手术、淋巴结切除术与未淋巴结切除术、辅助治疗与未辅助治疗的校正RR分别为0.80（0.36-1.77）、0.60（0.37-0.98）和0.89（0.55-1.46）。在高危组中，淋巴结切除术与未淋巴结切除术、辅助治疗与未辅助治疗的调整后死亡率分别为0.56（0.37-0.86）和0.60（0.38-0.96）。结论smis治疗子宫局限性疾病的效果不逊于剖腹手术。淋巴结切除术改善了所有疾病分期和组织学类型的预后。相比之下，辅助治疗仅改善高危患者的预后。
BackgroundThe goal of this study is to assess the oncologic outcomes of elderly patients who underwent hysterectomy for endometrial cancer across three variables: hysterectomy approach, lymph node resection, and adjuvant therapy.MethodsHospital records of patients aged ≥ 70 years who underwent hysterectomy for endometrial cancer were obtained from 19 institutions. Patients were categorized into three risk groups: low, intermediate, and high. In each group, disease-free survival and overall survival were compared according to hysterectomy approach, lymph node resection, and adjuvant therapy using Kaplan–Meier method. Cox regression analysis with a 95% confidence interval was performed to estimate relative risk (RR) of death.ResultsA total of 1246 patients were included. In the low-risk group, the adjusted RR for death for minimally invasive surgery (MIS) versus laparotomy and lymph node resection versus no lymph node resection were 0.64 (0.24–1.72) and 0.52 (0.24–1.12), respectively. In the intermediate-risk group, the adjusted RR for death for MIS versus laparotomy, lymph node resection versus no lymph node resection, and adjuvant therapy versus no adjuvant therapy were 0.80 (0.36–1.77), 0.60 (0.37–0.98), and 0.89 (0.55–1.46), respectively. In the high-risk group, the adjusted RRs for death for lymph node resection versus no lymph node resection and adjuvant therapy versus no adjuvant therapy were 0.56 (0.37–0.86) and 0.60 (0.38–0.96), respectively.ConclusionsMIS is not inferior to laparotomy in uterine-confined diseases. Lymph node resection improved the outcome for all disease stages and histological types. In contrast, adjuvant therapy improved the outcomes only in high-risk patients.
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DOI：
10.1097/igc.0000000000000605
发表时间：
2016-02-01
影响因子：
4.8
作者：
Clark, Leslie H.;Jackson, Amanda L.;Ko, Emily M.
通讯作者：
Ko, Emily M.
影响因子：
45.3
作者：
McCleary, Nadine J.;Meyerhardt, Jeffrey A.;Sargent, Daniel J.
通讯作者：
Sargent, Daniel J.
影响因子：
1.9
作者：
G. Kim;J. Ahn;S. Rha;Han Sang Kim;B. Kang;Min Whan Kim;Soon;J. Roh;H. Chung;N. Kim;S. Shin
通讯作者：
S. Shin
接受微创手术的子宫内膜癌患者的肿瘤学结果：一项回顾性观察研究
影响因子：
3.3
作者：
Tomohito Tanaka;Shoko Ueda;S. Miyamoto;S. Terada;Hiromi Konishi;Yuhei Kogata;S. Fujiwara;Yoshimichi Tanaka;Kohei Taniguchi;K. Komura;M. Ohmichi
通讯作者：
M. Ohmichi
影响因子：
1
作者：
Alemdaroglu S;Durdag GD;Baran SY;Simsek SY;Yetkinel S;Yaginc DA;Guler OC;Celik H
通讯作者：
Celik H