Study On The Relationship Between Adjuvant Therapy And Prognosis Of Stage Ⅰ Grade 3 Endometrioid Adenocarcinoma Postoperative

Objective: To explore the effects of different treatment methods on the prognosis of stage I grade 3 endometrioid adenocarcinoma patients and the relevantclinicopathological factors affecting the prognosis,so as to achieve accurate individual adjuvant therapy.Methods: A retrospective analysis of 96 patients with stage I grade 3 endometrioid adenocarcinoma was made in a single center(Liaoning Cancer Hospital)from January 1,2010 to December 31,2017.the clinical and pathological data,survival and recurrence were obtained through case system,outpatient system and telephone follow-up.The patients were divided into three groups according to different types of treatment(observation group,chemotherapy group,radiotherapy ± chemotherapy group).The overall survival and recurrence-free survival curves were drawn by Kaplan-Meier method,and the differences between groups were tested by Log-Rank method and stratified analysis COX proportional hazard model was used for univariate analysis and multivariate analysis to determine the effects of clinical and pathological factors on overall survival and recurrence-free survival.The difference was statistically significant(P<0.05).Results: A total of 96 patients were included in the study.The age in the observation group was older than that in the chemotherapy group and radiotherapy ±chemotherapy group(p < 0.05),but there was no significant difference in other clinicopathological indexes.Univariate COX regression analysis showed that the factors affecting OS and RFS were postoperative treatment mode,ER,BMI and age(p < 0.05).Multivariate COX regression analysis showed that the independent prognostic factors of OS were postoperative treatment,ER,BMI,age and diabetes(p<0.05).Multivariate COX regression analysis showed that the independent prognostic factors of RFS were postoperative treatment mode,ER,BMI and age.The 5-OS of observation group,chemotherapy group and radiotherapy ±chemotherapy were 66.7%,94.4% and 95.2%respectively(p < 0.05).The 5-PFS was 61.1%,91.7% and 95.2% respectively(p <0.05).The 5-OS of chemotherapy group and radiotherapy + chemotherapy group were94.4% and 93.9% respectively(p > 0.05).The 5-PFS is 91.7% and 93.9% respectively(p > 0.05).Conclusions: 1.Postoperative adjuvant therapy improves the prognosis of stage I grade3 endometrioid adenocarcinoma.2.There was no significant difference in overall survival rate and recurrence-free survival rate between adjuvant chemotherapy and radiotherapy+chemotherapy after operation.3.There was no significant difference in total survival rate and relapse-free survival rate between adjuvant chemotherapy and chemotherapy+radiotherapy after operation.4.The risk factors of OS in stage I G3 endometrioid adenocarcinoma were: no adjuvant treatment,age ≥ 60 years,ER negative,low BMI,diabetes.5.The independent risk factors affecting RFS of stage I G3 endometrioid adenocarcinoma were: no adjuvant treatment after operation,age ≥ 60 years old,ER negative,low BMI.