摘要
目的：分析Ⅳｂ期子宫内膜癌的临床特征，探讨与其预后的相关因素。方法：回顾性分析Ⅳｂ期子宫内膜癌的临床病理特征及随访结果。结果： １１例子宫内膜癌Ⅳｂ期患者，平均 ６１． １岁，绝经 ９例，平均绝经 １４．９年。临床症状主要是绝经后阴道不规则出血或血性分泌物（９／１１），其次为腹胀（４／１１）、腹部包块（３／１１），出现症状至就诊平均 １５．１个月。 １０例手术治疗， １例拒绝手术，仅行内分泌治疗，８例行术中、术后化疗，３例术后放疗；平均随访 １２．９个月，死亡 ６例，２年生存率 ２８％，３年生存率 １４％。盆腹腔复发 ３例均死亡，平均存活 ６．７个月，发生肺转移５例，３例死亡，平均存活１４．７个月。术后残存病灶＞２ｃｍ ４例，均因复发转移死亡，平均存活９个月，术后无残存病灶３例均存活。结论：Ⅳｂ期子宫内膜癌患者年龄较大，就诊较晚，多表现为绝经后不规则阴道出血，治疗以手术为主，尽可能切除所有病灶，并辅助放化疗，但预后较差，其相关因素主要有首次手术的彻底性，宫旁血管淋巴管受侵，病灶范围及复发转移部位等。
Objecthe: To analyze the clinicopathologic characteristics and prognostic factors of stage endometrial carcinoma. Methods: The clinical appearances, pathologic features, status of treatment and follow - up of 11 patients of endometrial carcinoma(stage Ⅳb)were analyzed retrospectively. Results: 11 patients, avarage age 61. 1 years,postmeno- pause 9 cases. The common symptoms of these patients were the vaginal irregular bleeding (9/11 ), abdominal distension(4/1), abdominal mass(3/11) and ascites(3/11). The median time interval from appearing symptom to diagnosis was 15. 1 months. 10 patients were operat- ed, and 8 patients received chemotherapy intra- or post - operation, 3 patients received ra- diation. All patients were followed - up 12.9 months (5 - 30months), and 6 cases died, 3 cases recurred in pelvic and abdominal cavity, 5 cases metastasized to lung. Survival rates of 2 - years and 3 - years were 28 .0%, 14.0% respectively.Conclusions:The prognosis of stage IVb endometrial carcinoma was very poor. The related factors of prognosis were opti- mal cytoreduction , the site of recurrence and metastasis, and lymph vescular invasion.
出处
《现代妇产科进展》
CSCD
2000年第6期412-415,共4页
Progress in Obstetrics and Gynecology
关键词
子宫内膜肿瘤
预后
外科手术
妇科
Endometrial neoplasms
Prognosis
Surgery
gynecology
