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Clinical Analysis of 600 Cases with Endometrial Carcinoma

Author: WangNa
Tutor: ChengJianXin;WangXiaoLing
School: Hebei Medical University
Course: Obstetrics and Gynaecology
Keywords: Endometrial cancer Prognostic factors Prognosis Cox proportional hazard model
CLC: R737.33
Type: Master's thesis
Year: 2009
Downloads: 158
Quote: 0
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Abstract


Objective: This study reviews the Fourth Hospital of Hebei Medical University, endometrial cancer 10 years complete clinical follow-up data to explore the impact on the prognosis of patients with endometrial cancer risk factors, and the relationships between factors. Methods: 1 January 1997 - December 2006 Fourth Hospital of Hebei Medical University, 31 during the day were treated by gynecologic surgery postoperative pathological diagnosis of endometrial cancer patients 600 cases, a detailed inspection of the clinical and pathological data and to improve its follow-up data. Establishment of clinical follow-up data Excel databases, endometrial cancer prognostic factors analysis. Using SPSS13.0 statistical software, using the Kaplan-Meier method to estimate survival, log-rank test was used for univariate analysis and the comparison group survival curve distribution, multivariate analysis using Cox regression model, the other count data using χ2 test, P lt ; 0.05 was considered statistically significant. Result: a group of 600 cases of endometrial carcinoma survival time items 2 to 136.5 months, with an average survival time of 57.39 ± 33.55 months, and the median survival time was 49.05 months, due to endometrial cancer death 109 cases (18.2 %). 2 years after surgery 1,3,5 overall survival rates were 96.8%, 89.9%, 82.1%. 3 The average age was 54.93 ± 8.36 years (26 to 78 years), with a median age of 55 years; lt; 55 years of age accounted for 47.7%, ≥ 55 years of age accounted for 52.3%. Four different ages histological grade, myometrial invasion difference was statistically significant (P lt; 0.05). lt; 55-year-old group, histological grade is low, a low incidence of deep myometrial invasion; ≥ 55 years group high histological grade, high incidence of deep myometrial invasion. Pathology and surgical - pathological staging in two age groups showed no significant difference (P gt; 0.05). Five different histological grade, myometrial infiltration in both groups before and after menopause, there was significant difference (P lt; 0.05). Premenopausal group, histological grade is low, a low incidence of deep myometrial invasion; postmenopausal group, high histological grade, high incidence of deep myometrial invasion. Pathology and surgical - pathologic staging in the two groups showed no significant difference (P gt; 0.05). 6 Univariate analysis showed: age, menopausal status, histological type, histological grade, surgical - pathological stage, tumor size, myometrial invasion, cervical invasion, ovarian metastasis, lymph node metastasis, treatment is affecting the prognosis of endometrial cancer factor. Multivariate analysis showed that: histological type, histological grade, surgical - pathological staging, cervical involvement of endometrial cancer is affecting independent prognostic factor. 7 clinicopathologic factors related to ovarian metastasis compared to histological grade, myometrial invasion, cervical involvement, tumor location, tumor size, lymph node metastasis, the differences were statistically significant differences (P lt; 0.05). High-level, deep myometrial invasion, cervical involvement, tumor filled, lymph node metastasis, the high incidence of ovarian metastasis. Age, pathological type was no significant statistical difference (P all gt; 0.05). 8 clinicopathologic factors related to lymph node metastasis compared with histological grade, myometrial invasion, cervical invasion, ovarian metastasis differences were statistically significant differences (P lt; 0.05). High-level, deep myometrial invasion, cervical invasion, ovarian metastasis, lymph node metastasis incidence. Age, histological type, tumor location, tumor size was no significant statistical difference (P all gt; 0.05). 9 Ⅰ endometrial cancer were hysterectomy double oophorectomy, sub extensive hysterectomy, hysterectomy after 5-year survival rates were 85.8%, 93.4%, 92.4%, the difference was not statistically significant (P gt; 0.05); Ⅰ endometrial cancer patients with pelvic lymph node dissection after 5-year survival rate was 92.3%, did not undergo lymphadenectomy 5-year survival rate was 89.4%, statistically significant difference between the two groups was not significant ( P gt; 0.05). Conclusion: a young former menopause endometrial carcinoma cell differentiation is good, a low incidence of deep myometrial invasion. 2 age, menopausal status, histological type, histological grade, surgical - pathological stage, tumor size, myometrial invasion, cervical invasion, ovarian metastasis, lymph node metastasis, treatment is affecting the prognosis of endometrial cancer risk factors. 3 histological type, histological grade, surgical - pathological staging, cervical involvement is affecting the prognosis of patients with endometrial cancer were independent risk factors. 4 poor tissue differentiation, deep myometrial invasion, cervical involvement, tumor location, tumor size, lymph node metastasis is a risk factor for ovarian metastasis. 5 poor tissue differentiation, deep myometrial invasion, cervical involvement, lymph node metastasis of ovarian metastasis is a risk factor. 6 not affect the extent of surgery in stage Ⅰ endometrial cancer prognostic factors, and expand the scope of operation does not significantly improve Ⅰ endometrial cancer survival rate. Seven patients with endometrial cancer prognosis and clinical pathological features closely related to the strict prognosis of endometrial cancer risk factors associated with systematic evaluation, according to the specific circumstances of the patient to develop individualized treatment programs, to obtain good effect.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Female genital tumors > Uterine tumors
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