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目的:探讨不同手术方式对Ⅰ期子宫内膜癌患者术后生存及复发的影响。方法:回顾性分析67例Ⅰ期子宫内膜癌患者的临床资料。根据手术方式不同将其分为两组,A组36例,行广泛子宫切除加盆腔淋巴结清扫术,B组31例,行全子宫加双附件切除术。分析两组5年生存率及复发情况。结果:A、B两组患者术后复发率分别为18%、17%,5年生存率分别为88%、90%。两组比较,差异无显著性(P>0.05)。随访发现共有11例复发,其中有7例发生远处转移,占64%。在术后有无化疗两种情况下,复发患者远处转移分别占40%、83%,差异有显著性(P<0.05)。结论:Ⅰ期子宫内膜癌患者可以采用全子宫加双附件切除术,扩大手术范围及行淋巴清扫术并不能提高生存率。远处转移在术后复发中占相当比例,术后辅助化疗对抑制盆腔外复发有一定帮助。
Objective: To investigate the effect of different surgical methods on the survival and recurrence of stage Ⅰ endometrial carcinoma patients. Methods: The clinical data of 67 patients with stage Ⅰ endometrial cancer were retrospectively analyzed. According to the different surgical methods, they were divided into two groups. Group A (36 cases) received extensive hysterectomy and pelvic lymphadenectomy. Group B (31 cases) received hysterectomy and double-attachment excision. Analysis of two groups of 5-year survival rate and recurrence. Results: The recurrence rates of group A and group B were 18% and 17%, respectively. The 5-year survival rates were 88% and 90% respectively. There was no significant difference between the two groups (P> 0.05). Follow-up found a total of 11 cases of recurrence, of which 7 cases of distant metastasis, accounting for 64%. In the two cases of postoperative chemotherapy, recurrence of distant metastasis patients accounted for 40%, 83%, the difference was significant (P <0.05). Conclusion: The patients with stage Ⅰ endometrial cancer can adopt total hysterectomy and double-attachment resection. Expanding the surgical range and performing lymphadenectomy can not improve the survival rate. Remote metastasis in postoperative recurrence accounts for a considerable proportion of postoperative adjuvant chemotherapy to inhibit recurrence of pelvic have some help.