[Prognostic factors in endometrial carcinoma]

From Apr. 1964 to Dec. 1985, the prognostic factors of 325 patients suffering from endometrial cancer treated by total hysterosalpingo-oophorectomy and bilateral pelvic lymph node dissection are analyzed. The results indicated that pelvic lymph node metastasis was related to the prognosis of this cancer, the 5-year survival rate was 86.56% in the negative group and 44.74% in the positive group (P less than 0.01). The factors leading to lymph node metastasis were: (1) The more advanced stage, the higher the pelvic lymph node metastatic rate (stage I 12.50%, II 27.16%, III 55.56%) (P less than 0.01); (2) The deeper the myometrial invasion, the higher the metastatic rate (no myometrial invasion 0%, superficial 8.25%, medium 36.96%, deep 40.74%) (P less than 0.01); (3) The higher the histological grade, the higher the metastatic rate (G1 12.50%, G2 21.57%, G3 30.00%) (P less than 0.05), implying that the histological grade is in direct proportion to the myometrial invasion and (4) The metastatic rate to pelvic lymph node is higher in the cervical invaded group than that without it (29.41% in the positive group and 15.42% in the negative group) (P less than 0.05). In this paper, the method of operation for endometrial cancer is discussed, suggesting that hysterosalpingo-oophorectomy be performed before opening the cavity of uterus. Should the cancer invades to a medium or deep degree in the myometrium, histological grade was high or the cervix was infiltrated pelvic lymph node dissection can be performed. After the operation, radiotherapy should be supplemented in those with positive lymph nodes.