Prognostic Factors in Endometrial Cancer Clinical Analysis
|School||Dalian Medical University|
|Course||Obstetrics and Gynaecology|
|Keywords||endometrial cancer prognosis|
Background: Endometrial cancer, also known as carcinoma of the corpus uteri, is gynecological common malignant tumors. The morbidity of endometrial cancer is the second highest after carcinoma of uterine cervix. It was reported that the number of the women with endometrial carcinoma has been more than 40,000 all over the world by 2008.Because of endometrial cancer in postmenopausal typical symptoms of abnormal bleeding and early detection through curettage and treated early, survival of patients prognosis is better, up to 70% five-year survival rate. But patients with risk factors whose prognostic survival rate is low. These risk factors include:①Deep muscle layer infiltration;②LNM;③Poor differentiated;④Special pathological type;⑤Lymphatic fistula clearance infiltrates;⑥Neoplasm staging. Other important fac-tors include age, CA-125 level,high blood pressure before treatment, glycuresis and obesity etc. Tumor prognostic factor is very complicated. Among various factors may also influence each other. So far, there are conflicting reports about the single factor influence.Objective: Prognostic factors are closely related with the survival of patients, so improve the prognosis of patients with survival time on the study appear very neces-sary. Exploring the prognosis of patients with endometrial cancer related factors and relationship between various factors, and systematically assessing its prognostic fac-tors, are convent for formulating rational treatment.Methods: Select January 2001 to January 2006, clinical and pathological data of 164 cases of endometrial cancer patients were treated in our hospital. Use SPSS 11.5 software for data processing system.The Kaplan-Meier method and Log-rank test was used for survival analysis. And with the Cox model for multiva- riate outcome analysis and comparison of prognostic factors.Result: 164 cases of endometrial cancer patients overall 5 year survival rate was 90.9%. This research was single factor analysis on 10may and endometrial cancer prognosis associated risk factors. In the analysis of the ten risk factors, just neoplasm staging (χ~2 =41.05, P = 0. 000), Miscellaneous pathology(χ~2 =15.38,P =0.0001), Lymphatic move case(χ~2 =28.01, P =0.000), Cervical infiltrating situation(χ~2 =4.84,P =0.0271),age(χ~2=11.96,P =0.0005), CA125 levels before treatment(χ~2 =9.36,P = 0.0067), can significantly influence endometrial cancer 5-year survival of patients. Tumor grade, the depth of muscle layer infiltration, and lymph vessel inva-sion surgical procedure on the survival of patients with endometrial cancer had no significant effect. After the analysis of the ten risk factors through Cox regression model for all variables and forward stepwise regression model, only age and tumor stage can significantly affect the survival of patients with endometrial cancer. And the tumor cell grade, pathological type, preoperative CA-125 levels, lymph node metastasis, cervical infiltration, depth of muscle layer infiltration, and surgical methods on survival in patients with endometrial cancer had no signifi-cant effect.Conclsion:CA-125 levels beforetreatment,age,tumor stage,lymphnode metastasis,pathological types of cervical infiltration on the survival of patients with endomet- rial cancer have significant impact. However, Cox multivariate analysis only age and tumor stage suggest that endometrial cancer were independent prognostic factors. Other factors affect the prognosis of endometrial cancer, remains to be further studied. Thus, for older patients with late stage cancer, but should focus on the postoperative adjuvant therapy to prolong survival time.