目的探讨全面分期手术后辅助化疗对早期特殊类型子宫内膜癌(浆液性癌、透明细胞癌、子宫癌肉瘤)复发及生存的影响。方法对Ⅰ~Ⅱ期特殊类型子宫内膜癌患者43例依照全面分期术后有无紫杉醇联合铂类化疗分为化疗组(24例)和未化疗组(19例),分析两组患者复发及生存情况。结果化疗组中位无瘤生存期(RFS)36个月(13~51个月),未化疗组12个月(6~59个月),化疗组5年RFS 68.6%,未化疗组51.8%,两组比较,差异无统计学意义(P>0.05)。化疗组5年总体生存率(OS)81.4%;未化疗组53.2%,差异有统计学意义(P<0.05)。结论全面分期术后辅以紫杉醇联合铂类化疗可提高早期特殊类型子宫内膜癌患者的总体生存率,术后辅助化疗是必要的。 Objective To investigate the effect of adjuvant chemotherapy after radical prostatectomy on the recurrence and survival of early special types of endometrial carcinoma (serous carcinoma, clear cell carcinoma and uterine carcinosarcoma). Methods Forty-three patients with stage Ⅰ-Ⅱ endometrial carcinoma were divided into chemotherapy group (n = 24) and non-chemotherapy group (n = 19) according to whether the patients were treated with paclitaxel and platinum-based chemotherapy. Survival. Results The median tumor-free survival (RFS) was 36 months (range, 13 to 51 months) in the chemotherapy group and 12 months (6 to 59 months) in the non-chemotherapy group. There was no significant difference between the two groups (P> 0.05). The 5-year overall survival rate (OS) was 81.4% in the chemotherapy group and 53.2% in the non-chemotherapy group (P <0.05). Conclusion The overall staging postoperatively combined with paclitaxel and platinum can increase the overall survival rate of patients with early special type of endometrial cancer. Postoperative adjuvant chemotherapy is necessary.