Clinical study of recurrent symptoms and prognosis of endometrial cancer
Objective To investigate the clinical characteristics of patients with recurrent endometrial cancer(EC)and provide corresponding suggestions for improving the prognosis of patients.Methods Retrospective study of 271 EC pa-tients who underwent surgical treatment in Anyang Maternal and Child Health Care Hospital from March 2013 to Novem-ber 2017 were selected.Through follow-up,237 patients and survival data were collected,and 34 cases were lost to follow-up.Among the follow-up patients,46 patients with recurrence were included in the recurrence group,and 191 patients with no recurrence were included in the non-recurrence group.The data of the patients were compared,the clinical manifestations of patients with recurrent EC were summarized,the influencing factors of patients with recurrent EC who did not receive treatment were analyzed,and the prognosis of patients with recurrent EC was compared.Results Compared with patients without recurrence,patients with recurrence were older,had a higher incidence rate of hypertension,higher proportion of endometrioid cancer,serous cancer and clear cell cancer,higher positive proportion of LVSI,higher ER negative rate,higher PR negative rate,higher P53 protein negative rate,higher rate of myometrial infiltration ＞1/2,and higher proportion of clinical stages Ⅲ and Ⅳ.There were 46 patients with recurrent EC,and the recurrence time of recurrent EC patients was 3-19 months,with a median time of 13 months.In the research,41.30％ of recurrent EC patients showed clinical symptoms after recurrence,while 15.22％ of them were unwilling to receive treatment after recurrence;older surgical age,recurrent symptoms,and lower family monthly income per capita were sig-nificant influencing factors for EC patients'unwillingness to receive further treatment after recurrence(P＜0.05).The postoperative recurrence time of symptomatic recurrence patients was 24(12,36)months,and the postoperative recur-rence time of asymptomatic recurrence patients was 22(14,34)months.The overall survival(OS)of patients with symp-tomatic recurrence within 5 years after surgery was 84.21％(16/19);the OS of asymptomatic recurrent patients at 5 years after surgery was 81.48％(22/27).Logrank test showed the difference was not statisticant significant(P＞0.05).The progression-free survival(PFS)of patients with symptomatic recurrence at 5 years after surgery was 63.16％(12/19);the PFS of asymptomatic recurrent patients at 5 years after surgery was 62.96％(17/27).Logrank test showed the difference was not statistically significant(P＞0.05).Conclusion Some patients with EC have symp-toms after recurrence.Pain is the most common recurrent symptom.Patients with recurrent symptoms have significantly shorter survival time after recurrence than patients without recurrent symptoms,which may be due to the fact that pa-tients with recurrent symptoms are unwilling to receive treatment after recurrence.
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