| Objective: Endometrial cancer is one of the most common malignant tumor in the female reproductive system,which derived from the endometrium and has a rising morbidity and mortality in worldwide and our country,and younger onset age.There are more researches and reports about comprehensive surgical staging endometrial carcinoma,but few about incomplete surgical staging endometrial carcinoma.The article aims to analyze retrospectively the clinicopathological information of incomplete surgical staging endometrial carcinoma,to evaluate the prognosis of the incomplete surgical staging endometrial carcinoma and related factors affecting prognosis and supply basis for clinical diagnosis.Methods:The clinicopathological data of 163 patients with incomplete surgical staging endometrial carcinoma underwent primary surgical treatment and confirmed by pathology from Jan 2008 to Dec 2014 in the Fourth Hospital of Hebei Medical University were reviewed and analyzed retrospectively.An Excel database was built with clinical follow-up survey and analyzed the prognostic indicator of the incomplete surgical staging endometrial carcinoma.SPSS16.0 statistical software was applied.Survival rates were calculated with Kaplan-Meier method.The prognosis factors were evaluated by univariate and multivariate analysis.Univariate analysis and the comparison between the survival rates were estimated by log-rank test.Multiple regression analysis were estimated by Cox hazards model.Results:1 The survival time of 163 cases with incomplete surgical staging endometrial carcinoma was 1-68 mouths,the average survival time was 33.4±20.483 mouths,the 5-year median survival time was 35 mouths.2 The average age of 163 patients was 55.96±12.687 years old(27-78 years old),the median age was 56 years old,<56(80 cases)acounted for 49.1%,≥56(83 cases)acounted for 50.9%.BMⅠ<30 Kg/m2(113 csaes)accouted for69.3%,≥ 30 Kg/m2(50 casses)accounted for 30.7%.3 There were 103 cases of simple vaginal bleeding,accounted for 63.2%,17 cases of abnormal vaginal drainage(10.4%);15 cases of both(9.2%);10 cases of hypogastralgia(6.1%);7 cases of menstrual disorder(4.3%);11 cases of no symptoms or low-abdominal mass(6.8%).Cases of premenopausal were 54(33.1%),postmenopausal cases were 109(66.9%).The cases combined with hypertension were 41(25.2%),9 cases combined with diabetes(5.5%),14 cases combined with both(8.6%),12 cases combined with heart disease(7.4%),3cases combined with stroke(1.8%),18 cases combined with infertility(11.0%).There were 139 cases of endometriod carcinoma(85.3%),137 cases of endometrial adenocarcinoma,2 case of adenoacanthous carcinoma;And 24 cases were nonendometriod carcinoma(14.7%),1 case of small cell carcinoma,1 case of mocoid carcinoma,20 cases of serous adenocarcinoma,2 cases of mixed adenocarcinoma.54 cases of high cell differentiation(38.8%),52 cases of middle cell differentiation(37.4%),33 cases of low cell differentiation(23.8%).Cases of no or superficial myometrial invasion(125 cases)accounted for 76.7%,deep invasion(38 cases)accounted for 23.3%.Cases of ovary metastasis(32 cases)accounted for 22.2%.36 cases of cervical stromal invasion(22.1%).94 cases of stageⅠ(57.7%),23 cases of stage(14.1%)Ⅱ,20 cases of stage(12.3%)Ⅲ,26 cases of stage Ⅳ(15.9%).74 cases of simple surgery(45.3%),25 cases of surgery and radiotherapy(15.4%),and 44 cases of surgery and chemotherapy(27.0%),20 cases of surgery and radiotherapy and chemotherapy(12.3%).4 The five-year overall survival rate was 83.4%.5 Univariate analysis showed the factors affecting the survival rate were menopausal state,histological type,tumor grade,operation-pathological stage,myometrial invasion,cervical stromal invasion,tumor size,ovarian metastasis and treatment.6 Multivariate analysis showed the factors affecting the survival rate were operation-pathological stage,tumor grade,cervical stromal invasion,myometrial invasion.7 Lymph node excision could not increase the five-year survival rate of the stage Ⅰ and Ⅱ with endometrial carcinoma.Conclusion:1 The five-year overall survival rate of incomplete surgical staging endometrial carcinoma of the Fourth Hospital of Hebei Medical University is 83.4%.2 Menopausal state,histological type,tumor grade,operation-pathological stage,myometrial invasion,cervical stromal invasion,tumor size,ovarian metastasis,treatment methods are related prognostic factors.3 Operation-pathological stage,tumor grade,cervical stromal invasion,myometrial invasion are independent prognostic factors.4 Lymph node excision can not increase the five-year survival rate of the stage Ⅰ and stage Ⅱ of endometrial carcinoma. |
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