Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus
Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus
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DOI：
10.1038/sj.bjc.6600698
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发表时间：
2003-01-27
影响因子：
8.8
通讯作者：
Matsuno, Y
中科院分区：
文献类型：
--
作者：
Kasamatsu, T;Onda, T;Matsuno, Y
本文回顾分析了腹膜细胞学检查对子宫内膜癌预后的意义。对280例手术分期、组织学局限于子宫的子宫内膜癌患者进行了临床病理检查。中位随访时间为62个月(范围12-135个月)。所有患者均接受了子宫切除、输卵管卵巢切除术和选择性淋巴清扫，仅3例患者接受了术后辅助治疗。术前未进行任何辅助治疗。总共有48例(17%)腹膜细胞学检查阳性。腹膜细胞学阳性和阴性患者的5年生存率分别为9.1%和95.00%，两组间差异无统计学意义(LOG-RANK，P=0.42)。细胞学阳性患者36个月无瘤生存率为90%，而细胞学阴性患者36个月无瘤存活率为94%，差异无统计学意义(log-ranking，P=0.52)。多因素比例风险模型显示，在分析的因素中(年龄、腹膜细胞学和肌层侵犯深度)，只有组织学分级是独立的预后因素(P=0.0003，95%CL3.02~40.27)。多因素分析显示，组织学分级(P=0.02，95%CI 1.21~9.92)也是影响无瘤生存的唯一独立预后因素。我们的结论是，腹膜细胞学阳性的存在不是局限于子宫的子宫内膜癌患者的独立预后因素，辅助治疗似乎对这些患者没有好处。(C)2003年英国癌症研究中心。
A retrospective analysis was performed to evaluate the prognostic significance of peritoneal cytology in patients with endometrial carcinoma limited to the uterus. A total of 280 patients with surgically staged endometrial carcinoma that was histologically confined to the uterus were examined clinicopathologically. The median length of follow-up was 62 (range, 12 - 135) months. All patients underwent hysterectomy and salpingo-oophorectomy with selective lymphadenectomy, and only three patients received adjuvant postoperative therapy. No preoperative adjuvant therapy was employed. In all, 48 patients (17%) had positive peritoneal cytology. The 5-year survival rate among patients with positive or negative peritoneal cytology was 9 1 or 95%, respectively, showing no significant difference (log-rank, P = 0.42). The disease-free survival rate at 36 months was 90% among patients with positive cytology, compared with that of 94% among patients with negative cytology, and the difference was not significant (log-rank, P = 0.52). Multivariate proportional hazards model revealed only histologic grade to be an independent prognostic factor of survival (P = 0.0003, 95% Cl 3.02 - 40.27) among the factors analysed (age, peritoneal cytology, and depth of myometrial invasion). Multivariate analysis revealed that histologic grade (P = 0.02, 95% Cl 1.21 -9.92) was also the only independent prognostic factor of disease-free survival. We concluded that the presence of positive peritoneal cytology is not an independent prognostic factor in patients with endometrial carcinoma confined to the uterus, and adjuvant therapy does not appear to be beneficial in these patients. (C) 2003 Cancer Research UK.