Prognostic Factors Affecting the Outcome of Endometrial Cancer
摘要
Purpose: To evaluate the prognostic factors and treatment outcomes in patients of endometrial cancer with treatments of surgery followed by radiotherapy. Materials and Methods: From August 1993 to April 2004, there were 69 patients diagnosed as endometrial cancer at our hospital. The median age at diagnosis was 55 years (ranged from 34 to 80 years). According to the FIGO staging system for cancer of the uterine body, 46 patients (67%) were stage Ⅰ, 8 (12%) were stage Ⅱ, 12 (17%) were stage Ⅲ, and 3 (4%) were stage Ⅳ. Fifty-eight patients (84%) had endometrioid carcinomas and 11 patients (16%) had non-endometrioid carcinomas: 4 were leiomyoscarcomas, 3 were MMMTs (malignant mixed mullerian tumor), 2 were papillary serous carcinomas, 1 was clear cell carcinoma, and 1 was mixed mucinous and small cell carcinoma. All 69 patients underwent surgery. Sixty-three (91%) of these 69 patients received postoperative adjuvant radiotherapy. Results: The median follow-up duration was 38 months (ranged from 8 to 129 months). During the follow-up period, 60 patients (87%) were alive, and 9 patients (13%) died. Three patients (4%) had local recurrence. Nine patients (13%) had distant metastases. The actuarial 5-year overall survival rate was 85%. In univariate analysis, stage was a significant prognostic factor for overall survival, favoring early stages (p=0.0298). Pathological cell type was also a prognostic factor for overall survival, favoring cell type of endometrioid carcinoma (p=0.0063). Lymph node metastasis was another significant prognostic factor affecting overall survival, favoring status without lymph node metastasis (p=0.0469). In multivariate analysis, pathological cell type continued to be a significant prognostic factor for overall survival, favoring cell type of endometrioid carcinoma (p=0.045). Conclusions: The 5-year overall survival rate of 85% was achieved in our report of patients of endometrial cancer treated with surgery followed by radiotherapy. Stage, patho