Impact of peritoneal cytology on survival of endometrial cancer patients treated with surgery and radiotherapy
Impact of peritoneal cytology on survival of endometrial cancer patients treated with surgery and radiotherapy
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DOI：
10.1038/sj.bjc.6601446
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发表时间：
2003-12-01
影响因子：
8.8
通讯作者：
Major, AL
中科院分区：
文献类型：
--
作者：
Tebeu, PM;Popowski, GY;Major, AL
IIIA期子宫内膜癌包括浆膜或附件浸润患者和仅腹膜细胞学阳性患者。在这项研究中，我们评估了腹膜细胞学检查对子宫内膜癌生存率的影响。1980年至1993年期间在日内瓦大学医院接受手术和放射治疗的所有子宫内膜癌患者均纳入研究。IIIA期癌症分为“细胞学”IIIA期（仅腹膜细胞学阳性）和“组织学”IIIA期（浆膜或附件浸润）。生存率采用Kaplan-Meier法进行分析，并采用log-rank检验进行比较。多因素回归分析腹腔细胞学检查对预后的重要性。该研究包括170例子宫内膜癌（112例1期，17例细胞学IIIA期，18例组织学IIIA期，9例IIIB+期）。细胞学IIIA期的疾病特异性生存率与1期无差异（分别为94 vs 88%，P = 0.5），但优于组织学IIIA期（分别为94 vs 51%，P < 0.01）。与I期患者相比，组织学IIIA期患者死于癌症的风险增加（HR 2.7，95% CI 1.0-7.7），而细胞学IIIA期患者则不然（HR 0.3，95% CI 0.3-2.0）。细胞学IIIA期子宫内膜癌的预后与I期相似，但比组织学IIIA期预后更好。进一步的研究，明确分离阶段和细胞学是必要的。
Stage IIIA endometrial cancer includes patients with serosal or adnexal invasion and patients with positive peritoneal cytology only. In this study, we assessed the impact of peritoneal cytology on endometrial cancer survival. All endometrial cancer patients receiving surgery and radiotherapy at the Geneva University Hospitals between 1980 and 1993 were included. Stage IIIA cancers were categorised into 'cytological' stage IIIA (only positive peritoneal cytology) and 'histological' stage IIIA (serosal or adnexal infiltration). Survival rates were analysed by Kaplan-Meier method and compared using log-rank test. The prognostic importance of peritoneal cytology was analysed by multivariate regression analysis. This study included 170 endometrial cancers (112 stage 1, 17 cytological stage IIIA, 18 histological stage IIIA, 9 stage IIIB+). Disease-specific survival of cytological stage IIIA was not different from stage 1 (94 vs 88% respectively, P = 0.5) but better than histological stage IIIA (94 vs 51% respectively, P < 0.01). Histological stage IIIA patients were at increased risk to die from cancer compared to stage I patients (HR 2.7, 95% CI 1.0-7.7), while cytological stage IIIA patients were not (HR 0.3, 95% CI 0.3-2.0). Cytological stage IIIA endometrial cancer has similar prognosis as stage I and better prognosis than histological stage IIIA. Additional research, definitively separating stage and cytology is warranted.