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目的:探讨不同手术方式及术后补充放疗的价值。方法:将1990年1月~2000年7月住院治疗并有完整资料的136例I期子宫内膜癌患者分成单纯手术组63例,术后放疗组73例,根据手术方式的不同再进行分组。手术方式为全子宫双附件切除+盆腔淋巴结清扫术或(次)广泛全子宫双附件切除+盆腔淋巴结清扫术;术后放疗方式为全盆外照射(和)或腔内后装治疗。分别比较单纯手术组与术后放疗组以及不同手术方式患者的5年生存率及局部复发率。结果:单纯手术组与术后放疗组以及不同手术方式患者的5年生存率的差异均无显著性(P>0.05),局部复发率比较除Ic患者有差异外(P<0.05),Ⅰa、Ⅰb患者均无差异(P>0.05)。结论:Ⅰ期子宫内膜癌患者全子宫双附件切除的手术范围已经足够,扩大手术范围并不能提高生存率,盆腔淋巴结清扫是必要的。术后补充放疗仅能降低Ⅰc期患者的局部复发率,而对Ⅰa、Ⅰb期患者无益。
Objective: To explore the different surgical methods and the value of postoperative radiotherapy. Methods: One hundred and sixty-three patients with stage I endometrial cancer hospitalized from January 1990 to July 2000 with complete data were divided into three groups: operation alone group (63 cases) and postoperative radiotherapy group (73 cases), which were divided into groups according to different operation methods . Surgical methods for the whole hysterectomy double attachment removal + pelvic lymph node dissection or (wide) wide uterine double attachment removal + pelvic lymph node dissection; postoperative radiotherapy for the whole basin external irradiation (and) or intracavitary after-treatment. The 5-year survival rates and the local recurrence rates of patients in the simple operation group, the postoperative radiotherapy group, and the different surgical methods were compared. Results: There was no significant difference in the 5-year survival rates between the surgery group and the postoperative radiotherapy group and the different surgical methods (P> 0.05). The local recurrence rate was significantly different from that of the Ic patients (P <0.05) Ib patients were no difference (P> 0.05). Conclusions: The surgical scope of total hysterectomy in patients with stage Ⅰ endometrial cancer is sufficient, and expanding the scope of surgery does not improve the survival rate. Pelvic lymph node dissection is necessary. Postoperative radiotherapy can only reduce the local recurrence rate in patients with stage Ⅰc, and Ⅰ a, Ⅰ b of the patients benefit.