Prognosis analysis of radical or modified radical hysterectomy and simple hysterectomy in patients with stage Ⅱ endometrial cancer.
10.3760/cma.j.cn112141-20230314-00120
- Author:
Zhuo Yu ZHAI
1
;
He LI
1
;
Li Wei LI
1
;
Zhi Hui SHEN
1
;
Xiao Bo ZHANG
2
;
Zhi Qi WANG
1
;
Jian Liu WANG
1
Author Information
1. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
2. Department of Pathology, Peking University People's Hospital, Beijing 100044, China.
- Publication Type:Journal Article
- MeSH:
Female;
Humans;
Adult;
Middle Aged;
Aged;
Disease-Free Survival;
Retrospective Studies;
Neoplasm Staging;
Prognosis;
Endometrial Neoplasms/pathology*;
Hysterectomy/methods*;
Postoperative Complications/epidemiology*;
Uterine Cervical Neoplasms/pathology*
- From:
Chinese Journal of Obstetrics and Gynecology
2023;58(6):442-450
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the prognosis and perioperative situation of patients with stage Ⅱ endometrial cancer (EC) between radical hysterectomy/modified radical hysterectomy (RH/mRH) and simple hysterectomy (SH). Methods: A total of 47 patients diagnosed EC with stage Ⅱ [International Federation of Gynecology and Obstetrics (FIGO) 2009] by postoperative pathology, from January 2006 to January 2021 in Peking University People's Hospital, were analyzed retrospectively. The patients were (54.4±10.7) years old, and the median follow-up time was 65 months (ranged 9-138 months). They were divided into RH/mRH group (n=14) and SH group (n=33) according to the scope of operation. Then the prognosis of patients between the groups were compared, and the independent prognostic factors of stage Ⅱ EC were explored. Results: (1) The proportions of patients with hypertension in RH/mRH group and SH group were 2/14 and 45% (15/33), the amounts of intraoperative blood loss were (702±392) and (438±298) ml, and the incidence of postoperative complications were 7/14 and 15% (5/33), respectively. There were significant differences (all P<0.05). (2) The median follow-up time of RH/mRH group and SH group were 72 vs 62 months, respectively (P=0.515). According to Kaplan-Meier analysis and log-rank method, the results showed that there were no significant difference in 5-year progression-free survival (PFS) rate (94.3% vs 84.0%; P=0.501), and 5-year overall survival rate (92.3% vs 92.9%; P=0.957) between the two groups. Cox survival analysis indicated that age, pathological type, serum cancer antigen 125 (CA125), and estrogen receptor (ER) status were associated with 5-year PFS rate (all P<0.05). But the scope of hysterectomy (RH/mRH and SH) did not affect the 5-year PFS rate of stage Ⅱ EC patients (P=0.508). And level of serum CA125 and ER status were independent prognostic factors for 5-year PFS rate (all P<0.05). Conclusions: This study could not find any survival benefit from RH/mRH for stage Ⅱ EC, but increases the incidence of postoperative complications. Therefore, the necessity of extending the scope of hysterectomy is questionable.
