The Clinical Analysis Of 198 Cases With Endometrial Carcinoma

OBJIECTIVE: To compare the differences between clinical (FIGO 1971) and surgical-pathologic (FIGO 1988) staging of endometrial carcinoma and to study the clinical value of clinical and surgical-pathological staging for endometrial carcinoma and to analyzed the prognologic factors of endometrial carcinoma.METHODS: Clinical and pathological data of one hundred ninety-eight patients with endometrial carcinoma surgically treated from January 1995 to December 2001 were retrospectively reviewed in Affiliated Hospital Of Medical College Qing Dao Universty. The clinical staging , histologic grading and pathological type of these patients between preoperation and postoperation. The stagings were analyzed with regards to the prognologic factors of endometrial carcinoma.RESULTS: The total differences between clinical and surgical-pathologic staging were 46.4% (92/198), of which stage I was 24.5%, stage II 84.6%, stage III 4 of 10 cases, stage IV 0 of 4 cases. The total differences of pathological type between preoperation and postoperation were 9.5% (19/198), of which endometrioid adenocarcinoma was 5.9%, adenosquamous carcinoma 40.0%, adenoacanthoma 2 of 8 cases, papillary serous carcinoma 1 of 4 cases. The total differences of histologic grade were 18.9% (36/190), of which G1 was 14.1%, G2 28.3%, G3 2 of 10 cases. The metastasis rate of pelvic lymph nodes was 9.1% (17/186), in stage I 3.0%, stage II 5.2%. The positive rate of paraaortic lymph nodes was 10% (7/68). Thirty-five patients (17.6%) with extrauterine pelvic metastasis were found, of which stage I was 13.2%, stage II 14.1%. 8.0% with ovarian metastasis, in stage I 10.3%, in stage II 1.3%. The other pelvic metastasis rate were 9.5%, containing extrauterine infiltration, round ligament metastasis and pelvic peritoneum planting. The postive rate of peritoneal cytological was 8.0%. There were three postive in four appendixs excised and five postive in thirty-two omentum excised. By univariate analysis, stages, depth of myometrial invasions, histologic grade and pathological type were related to the metastasis of pelvic and abdominal cavity and prognosis (P<0.05).CONCLUSIONS:1 There are differences between clinical (FIGO 1971) and surgical-pathologic(FIGO 1988) staging of endometrial carcinoma, especially stage II. So we should attach importance to stage II in clinical staging.2 Clinical stage, depth of myometrial invasion, histologic grade and pathological type were related to the metastasis of pelvic and abdominal cavity and prognosis.3 The surgical-pathological staging is more accurate than the clinical staging. The surgical-pathological staging is able to define the real extent of endometrial carcinoma and assess prognosis objectively.