Treatment options for recurrent endometrial adenocarcinoma are limited. In those cases, secondary surgical procedures such as pelvic exenteration form the only possible curative approach. The aim of this study was analyzing the outcomes of patients who underwent pelvic exenteration during the treatment of recurrent endometrial cancer intending to identify prognostic factors. More than 300 pelvic exenterations were performed. Fifteen patients were selected that received pelvic exenteration for recurrent endometrial adenocarcinoma. Data regarding patient characteristics, indication for surgery, complete cytoreduction, tumor grading and p53- and L1CAM-expression were collected and statistically evaluated. Univariate Cox regression was performed to identify predictive factors for long-term survival. The mean survival after pelvic exenteration for the whole patient population was 22.7 months, with the longest survival reaching up to 69 months. Overall survival was significantly longer for patients with a curative treatment intention (p= 0.015) and for patients with a well or moderately differentiated adenocarcinoma (p= 0.014). Complete cytoreduction seemed favorable with a mean survival of 32 months in contrast to 10 months when complete cytoreduction was not achieved. Pelvic exenteration is a possible treatment option for a selected group of patients resulting in a mean survival of nearly two years, offering a substantial prognostic improvement.
复发性子宫内膜腺癌的治疗选择有限。对于此类病例，盆腔廓清术等二次手术是唯一可能的根治性方法。本研究旨在分析复发性子宫内膜癌患者接受盆腔廓清术的预后情况，以确定影响预后的因素。研究期间共实施超过300例盆腔廓清术，其中筛选出15例因复发性子宫内膜腺癌接受该手术的患者。收集患者临床特征、手术指征、肿瘤细胞减灭完整性、肿瘤分级及p53与L1CAM表达数据并进行统计学评估。通过单变量Cox回归分析确定长期生存的预测因素。全组患者盆腔廓清术后平均生存期为22.7个月，最长生存期达69个月。以根治为目的接受治疗的患者（p=0.015）及高/中分化腺癌患者（p=0.014）总生存期显著延长。实现完全肿瘤细胞减灭的患者平均生存期达32个月，而未实现者仅为10个月，显示完全减灭具有显著生存优势。对于经过筛选的患者群体，盆腔廓清术可作为有效治疗选择，使患者获得近两年的平均生存期，显著改善预后。
Pelvic Exenteration for Recurrent Endometrial Cancer: A 15-Year Monocentric Retrospective Study
肿瘤(癌症)患者之家