Frequency and Determinants of Lymphadenectomy in Endometrial Carcinoma: A Population-Based Study From Northern Italy
Frequency and Determinants of Lymphadenectomy in Endometrial Carcinoma: A Population-Based Study From Northern Italy
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子宫内膜癌淋巴结切除术的频率和决定因素：意大利北部的一项基于人群的研究
DOI：
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发表时间：
2001
影响因子：
3.7
通讯作者：
D. Amadori
中科院分区：
文献类型：
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作者：
A. Amadori;L. Bucchi;G. Gori;F. Falcini;L. Saragoni;D. Amadori
摘要背景：子宫内膜癌手术病理分期的盆腔和腹主动脉旁淋巴结切除术在临床实践中的扩散仅通过妇科肿瘤学家的问卷调查进行评估。没有基于人口的信息。
研究方法：在这项基于人群的罗马涅癌症登记处登记的可手术子宫内膜癌病例的研究中，（北方意大利）1987年至1994年期间，（年龄、时间段、出生地、居住地、治疗地、婚姻状况）和病理因素采用多因素Logistic回归分析评估了组织学类型、肿瘤分级、肌层浸润、疾病向宫颈、浆膜、附件和阴道的扩展与淋巴结切除术可能性的关系。
结果：在300例可能合格的病例中，276例（92%;中位年龄63岁;范围33-87岁）获得了足够的信息。未观察到主动脉旁淋巴结切除术病例。86例（31%）行盆腔淋巴结清扫术。盆腔淋巴结清扫的可能性与肿瘤分级（正相关）、治疗地点和婚姻状况有关。所有其他变量，包括肌浸润和疾病扩展到子宫颈和子宫以外，没有任何影响。
结论：最可能的解释结果包括接受目前的手术病理分期标准和标准诊断技术的术前和术中评估肌浸润和宫外扩散的使用不足。
AbstractBackground: The diffusion of pelvic and para-aortic lymphadenectomy for the surgical pathological staging of endometrial carcinoma into clinical practice has been evaluated only with questionnaire surveys of gynecological oncologists. No population-based information is available.
Methods: In this study of operable endometrial carcinoma cases registered by the population-based Romagna Cancer Registry (northern Italy) between 1987 and 1994, the association of demographic (age, time period, place of birth, place of residence, place of treatment, and marital status) and pathological factors (histological type, tumor grade, myoinvasion, and extension of disease to cervix, serosa, adnexa, and vagina) with the probability of lymphadenectomy was evaluated by multiple logistic regression analysis.
Results: Of the 300 potentially eligible cases, sufficient information was obtained for 276 (92%; median age, 63 years; range, 33–87 years). No case of para-aortic lymphadenectomy was observed. Pelvic lymphadenectomy was performed in 86 (31%) cases. The probability of pelvic lymphadenectomy was related to tumor grade (positive association), place of treatment, and marital status. All other variables, including myoinvasion and extension of disease to the cervix and beyond the uterus, had no effect whatsoever.
Conclusions: The most likely interpretations of results include poor acceptance of current surgical pathological staging criteria and insufficient use of standard diagnostic techniques for preoperative and intraoperative assessment of myoinvasion and extrauterine spread.
手术分期的实践及其对 I 期子宫内膜癌患者辅助治疗建议的影响。
影响因子：
4.7
作者：
GretzHF3rd;Economos,K;Husain,A;Lesser,M;Kaplan,E;Caputo,TA;Reynolds,RK;Johnston,CM;Pearl,ML;Roberts,JA
通讯作者：
Roberts,JA