早期子宫内膜类子宫内膜癌患者复发的危险因素，可以完全缓解生育能力的荷尔蒙治疗
Risk factors for the recurrence in patients with early endometrioid endometrial cancer achieving complete remission for fertility-sparing hormonal treatment
影响因子:4.10000
分区:医学2区 Top / 妇产科学1区 肿瘤学2区
发表日期:2024 Dec
作者:
Eun Bi Jang, A Jin Lee, Kyeong A So, Sun Joo Lee, Ji Young Lee, Tae Jin Kim, Eunhyang Park, Soon-Beom Kang, Seung-Hyuk Shim
摘要
这项研究旨在评估早期子宫内膜类子宫内膜癌（EC）患者的复发危险因素，这些患者通过减肥激素治疗（FST）获得了完全反应（CR）。我们回顾性地分析了在两个机构中接受了假定的IA和1级子宫内膜EC的FST的患者。同时使用了甲状腺酸糖剂（MPA） - 释放宫内遗传内装置（LNG-IUD）。维护疗法涉及在实现CR后不试图立即怀孕的人维持LNG-iuds。 COX回归分析用于鉴定Cr.Among 178例子宫内膜类药物EC患者的临床病理变量（RFS），并获得了FST，获得了FST，142（79.8％）获得了CR。实现CR和FST持续时间的中位时间分别为10个月（范围1-34）和14个月（范围3-49）。在44个月的中位随访期（6-143范围）中，59.9％（85/142）的患者复发，CR后的RFS中位14个月（范围1-123）。 In multivariable analysis, age > 35-years (hazard ratio (HR) 1.892, 95 % confidence interval (CI) 1.224-2.923; P < 0.05) and pregnancy after the first CR (HR 0.203, 95 % CI 0.093-0.444; P < 0.05) were significantly associated with RFS.Older age and non-pregnancy status may be risk factors for recurrence after CR.因此，患有这些疾病的患者应进行严格的随访，包括成像和组织学检查，以检测CR后的复发。
Abstract
This study aimed to assess the recurrence risk factors in patients with early-stage endometrioid endometrial cancer (EC) who achieved a complete response (CR) through fertility-sparing hormonal treatment (FST).We retrospectively analyzed patients who received FST for presumed stage IA and grade 1 endometrioid EC at two institutions. Medroxyprogesterone (MPA)- and levonorgestrel-releasing intrauterine devices (LNG-IUD) were used concurrently. Maintenance therapy involved maintaining the LNG-IUDs in situ for those who did not attempt to conceive immediately after achieving CR. Cox regression analysis was used to identify clinicopathological variables for recurrence-free survival (RFS) following CR.Among 178 patients with endometrioid EC who received FST, 142 (79.8 %) achieved CR. The median time to achieve CR and the median FST duration were 10 months (range 1-34) and 14 months (range 3-49), respectively. During the median follow-up period of 44 months (range 6-143), 59.9 % (85/142) of patients had recurrence, with a median RFS of 14 months (range 1-123) after CR. In multivariable analysis, age > 35-years (hazard ratio (HR) 1.892, 95 % confidence interval (CI) 1.224-2.923; P < 0.05) and pregnancy after the first CR (HR 0.203, 95 % CI 0.093-0.444; P < 0.05) were significantly associated with RFS.Older age and non-pregnancy status may be risk factors for recurrence after CR. Therefore, patients with these conditions should undergo stringent follow-up, including imaging and histological examinations, to detect recurrence after CR.