遵守ESGO指导方针和对子宫内膜癌肥胖患者的生存的影响:一个多中心的回顾性研究
Samia Ouasti1, Johanna Ilic1, Camille Mimoun2
1Department of Obstetrics Gynaecology and Reproductive Medicine, Sorbonne University - Tenon Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.
概括
对于肥胖的子宫内膜癌患者,特别是淋巴结分期的手术指南的遵守率较低. 尽管如此,他们接受了更多的辅助疗法,并且表现出更好的无复发生存率.
科学领域:
- 妇科瘤学 妇科瘤学
- 手术瘤学手术瘤学
- 肥胖医学 肥胖医学
背景情况:
- 肥胖是子宫内膜癌的重要危险因素,增加了手术复杂性.
- 对患有子宫内膜癌的病态肥胖患者 (BMI>40 kg/m2) 的管理对医疗保健提供者来说是一个挑战.
研究的目的:
- 评估欧洲妇科瘤学会 (ESGO) 在患有严重肥胖的子宫内膜癌患者的指导方针的遵守情况.
- 评估肥胖对子宫内膜癌患者整体存活率和无复发存活率的影响.
主要方法:
- 在11个FRANCOGYN集团研究所对2375名子宫内膜癌患者进行了回顾性分析.
- 患者被分为三个组:致病性肥胖 (BMI>40 kg/m2),肥胖 (BMI 30-40 kg/m2) 和正常/超重 (BMI <30 kg/m2).
- 对手术管理,淋巴结分期和辅助疗法进行了评估.
主要成果:
- 与肥胖 (44%) 和正常/超重 (48%) 组相比,患有病态肥胖的组 (30%) 的手术指南遵守率最低 (p<0.001),主要是由于淋巴结分期减少.
- 致病性肥胖患者比肥胖 (52%) 或正常/超重 (46%) 患者 (p<0.001) 更有可能接受推的辅助治疗 (61%).
- 体重对整体存活率没有显著影响 (p=0.6),但患有致病性肥胖的患者表现出更好的无复发存活率 (p=0.04).
结论:
- 对手术管理指导方针的遵守,特别是淋巴结分期,在患有病态肥胖的子宫内膜癌患者中明显较低.
- 尽管手术指南的遵守率较低,但患有致病性肥胖症的患者更频繁地接受了适当的辅助疗法.
- 患有致病性肥胖症的患者表现出更好的无复发生存率,可能与更有利的瘤特征有关.
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