早期子宫内膜癌大剂量孕激素治疗后行手术治疗的相关因素分析

发布时间：2018-03-31 07:42

  本文选题：子宫内膜癌　切入点：子宫内膜增生　出处：《北京协和医学院》2016年硕士论文

【摘要】：目的：总结140例连续大剂量孕激素治疗的早期子宫内膜癌/内膜不典型增生患者中22例接受手术治疗的临床资料,分析其手术原因及改行手术治疗的相关因素及肿瘤结局。方法：1991年11月至2015年4月北京协和医院收治的早期子宫内膜癌/内膜不典型增生共140例行连续口服大剂量孕激素治疗,每3个月评估子宫内膜变化情况,患者放弃保守治疗、治疗期间疾病进展或出现严重不良反应时则随时转行手术治疗。病理证实完全缓解后予个体化后续治疗。回顾性分析大剂量孕激素治疗后行手术治疗的原因及相关因素。结果：研究纳入89例子宫内膜癌(EC)和51例不典型增生(AH),中位年龄31岁。大剂量孕激素治疗102例(72.9%)获CR,11例(7.8%)获PR,5例(3.6%)SD,1例(0.7%)PD。22例转行手术治疗。中位随访时间26(3-151)月。AH组和EC组手术率分别为11.8%和18.0%(P0.05)：MA组和MPA组手术率分别为14.5%和16.7%(P0.05)；年龄≤35岁和35岁者手术率分别为13.3%和41.7%(P0.05)BMI25kg/m2和≥25kg/m2者手术率分别为10.7%和23.2%(P0.05)。年龄35岁是孕激素治疗后手术治疗的高危因素。结论：早期子宫内膜癌／不典型增生连续口服大剂量孕激素可获得较高逆转率；年龄35岁是终止保守治疗接受手术治疗的重要影响因素。
[Abstract]:Objective : To summarize the clinical data of 22 patients with early endometrial carcinoma / endometrial atypical hyperplasia treated with continuous large - dose gestagen in the early stage of treatment . The causes and related factors of operation were analyzed retrospectively . Results : The results showed that 89 cases of endometrial carcinoma ( EC ) and 51 cases of atypical hyperplasia ( AH ) were treated by operation . Results : The results showed that the operation rates of the patients with advanced endometrial carcinoma ( EC ) and 51 cases were CR , 11 cases ( 0.7 % ) were treated with CR , 11 cases ( 0.7 % ) were treated with PR , 5 cases ( 3.6 % ) SD , 1 ( 0.7 % ) PD . 22 cases underwent surgery . The operative rates of AH and EC were 11.8 % and 18.0 % ( P0.05 ) .
The operative rates of patients aged 鈮，

本文编号：1689820