Extrauterine spread in endometrial carcinoma clinically confined to the uterus.
Extrauterine spread in endometrial carcinoma clinically confined to the uterus.
复制标题
子宫内膜癌的宫外扩散临床上局限于子宫。
DOI：
10.1016/0090-8258(85)90228-8
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发表时间：
1984
影响因子：
4.7
通讯作者：
Sidney S. Chen
中科院分区：
文献类型：
--
作者：
Sidney S. Chen
从1975年7月到1983年4月，237名患者在长岛犹太-希尔赛德医疗中心接受了子宫内膜癌的初步治疗。本研究包括74例I期子宫内膜癌患者和20例II期子宫内膜癌患者，他们接受了剖腹手术，术前未接受放射治疗。本研究的目的是确定临床上局限于子宫的子宫内膜癌的宫外扩散的患病率，并将风险变量与这种扩散相关联。评估的参数包括腹膜后淋巴结转移、附件受累、腹膜植入物和腹膜细胞学检查。子宫外播散的总体患病率为23.4%（I期，18.9%; II期，40.0%）。淋巴结转移、附件受累、腹膜种植和腹膜细胞学阳性率分别为18.7%、7.4%、4.3%和8.5%。表面扩散和风险变量之间没有正相关关系。表面扩散与腹腔细胞学检查呈正相关（87.5%）。阳性淋巴结与肿瘤生长超过1/3的子宫内膜表面（P< 0.001）、大体宫颈受累（P<0.001）、深肌层浸润（P <0.001）、宫腔长度、3级肿瘤、乳头状腺癌（40%）和疾病分期直接相关。本小系列中I期和II期的5年生存率分别为77.8%和55.6%。16例II期根治性膀胱切除术的并发症是轻微和短暂的。由于临床上局限于子宫的子宫内膜癌经常发生宫外扩散，因此在确定性治疗前，I期和II期疾病可能需要剖腹探查和腹膜细胞学检查。
From July 1975 to April 1983, 237 patients had primary treatment for endometrial cancer at the Long Island Jewish-Hillside Medical Center. Included in this study were 74 of these patients with Stage I and 20 with Stage II endometrial carcinoma who underwent laparotomy without preoperative radiation. The purpose of the study was to determine the prevalence of extrauterine spread in endometrial carcinoma clinically confined to the uterus and to correlate risk variables with this spread. The parameters assessed were retroperitoneal nodal metastases, adnexal involvement, peritoneal implants and peritoneal cytology. The overall prevalence of extrauterine spread was 23.4% (Stage I, 18.9%; Stage II, 40.0%). The rate of nodal metastasis, adnexal involvement, peritoneal implant, and positive peritoneal cytology were 18.7, 7.4, 4.3, and 8.5%, respectively. No positive relationship was demonstrated between surface spread and risk variables. There was positive correlation between surface spread and peritoneal cytology (87.5%). Direct correlations were found between positive nodes and tumor growth over more than one-third of the endometrial surface (P< 0.001), gross cervical involvement (P< 0.001), deep myometrial invasion (p< 0.001), length of uterine cavity, grade 3 tumor, papillary adenocarcinoma (40%), and stage of disease. Five-year survival rate of Stage I and Stage II in this small series was 77.8 and 55.6%. Complications of 16 radical hysterectomies in Stage II were minimal and transient. Because of frequent extrauterine spread in endometrial carcinoma clinically confined to the uterus, an exploratory laparotomy and peritoneal cytology may be desirable in Stage I and II disease before definitive treatment.