晚期子宫内膜癌细胞减灭术20年：一项单中心回顾性队列研究
Twenty Years of Cytoreductive Surgery for Advanced Endometrial Carcinoma: A Single-Center Retrospective Cohort Study.
摘要(中文译文)
子宫内膜癌（EC）是最常见的妇科恶性肿瘤，晚期患者生存预后不佳。目前的治疗策略包括肿瘤细胞减灭术（CRS）及（新）辅助化疗，但生存率仍然有限。本研究评估了Erasmus MC在20年期间的总生存期（OS）和手术结局，包括CRS结局及手术并发症。本回顾性队列研究纳入2000年至2020年间在Erasmus MC接受治疗的FIGO III期或IV期子宫内膜癌女性患者。数据来源于荷兰综合癌症组织，并通过病历回顾进行补充。采用统计分析评估基于FIGO分期、组织学类型、分子特征、CRS结局及CRS类型的OS差异。共纳入188例患者，中位年龄为66岁。大多数患者接受了手术及额外的化疗和放疗。共有64例患者（59.3%）接受了初次CRS，44例患者（40.7%）接受了间歇性CRS。完全CRS的患者较满意CRS和不完全CRS的患者具有显著的生存优势（HR 0.56；95% CI 0.33-0.96，= 0.036）。初次CRS与间歇性CRS之间的比较显示OS无显著差异（HR 1.42；95% CI 0.82-2.44，= 0.207）。33.1%的患者发生手术并发症，其中感染最为常见。两例患者死于严重并发症。本研究强调了手术在晚期子宫内膜癌管理中的主导作用。完全CRS通常可以实现，并提供显著的生存优势。然而，约三分之一的患者经历手术并发症。
Abstract
Endometrial carcinoma (EC), the most common gynecological malignancy, is associated with unfavorable survival in advanced stages. Treatment strategies now include cytoreductive surgery (CRS) and (neo)adjuvant chemotherapy, but survival rates remain limited. This study evaluates overall survival (OS) and surgical outcomes, including outcomes of CRS and surgical complications, over a 20-year period at the Erasmus MC. This retrospective cohort study includes women diagnosed with FIGO stage III or IV EC between 2000 and 2020 who received treatment at the Erasmus MC. Data were collected from the Netherlands Comprehensive Cancer Organization and supplemented by medical record reviews. Statistical analyses were conducted to evaluate differences in OS based on FIGO stage, histological type, molecular characteristics, CRS outcome, and type of CRS. A total of 188 patients were included, with a median age of 66 years. Most patients received surgery and additional chemotherapy and radiotherapy. A total of 64 patients (59.3%) underwent primary CRS, and 44 patients (40.7%) underwent interval CRS. Patients with complete CRS had a significant survival advantage over patients with optimal and incomplete CRS (HR 0.56; 95% CI 0.33-0.96, = 0.036). Comparison between primary and interval CRS revealed no significant difference in OS (HR 1.42; 95% CI 0.82-2.44, = 0.207). Surgical complications occurred in 33.1% of patients, with infections most common. Two patients died from severe complications. This study highlights the predominant role of surgery in the management of advanced EC. Complete CRS is often achievable and offers significant survival advantage. However, approximately one-third of patients experience surgical complications.
如何引用
AMA
Britt Kilkens, Eva Maria Roes, Ingrid Boere, Jan-Willem Mens, Heleen van Beekhuizen. Twenty Years of Cytoreductive Surgery for Advanced Endometrial Carcinoma: A Single-Center Retrospective Cohort Study.. Cancers. 2026; doi:10.3390/cancers18101617.
APA
Britt Kilkens, Eva Maria Roes, Ingrid Boere, Jan-Willem Mens, Heleen van Beekhuizen (2026). Twenty Years of Cytoreductive Surgery for Advanced Endometrial Carcinoma: A Single-Center Retrospective Cohort Study.. Cancers. https://doi.org/10.3390/cancers18101617
GB/T 7714
Britt Kilkens, Eva Maria Roes, Ingrid Boere, Jan-Willem Mens, Heleen van Beekhuizen. Twenty Years of Cytoreductive Surgery for Advanced Endometrial Carcinoma: A Single-Center Retrospective Cohort Study.[J]. Cancers, 2026 doi:10.3390/cancers18101617.
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