Clinicopathological study of endometrial cancer was performed on 36 cases at Shiga University of Medical Science Hospital for eight years since 1979.
The average age of 36 patients was 56.8 year-old and the range 37 to 73 year-old. In 32 of 36 cases, the abnormal genital bleeding was noted as a chief complaint.
In the FIGO clinical stage (preoperative clinical stage), 25 cases were in stage I, 8 in stage II, 1 in stage III, 2 in stage IV. In the surgical stage, 19 cases were in stage I, 5 in stage II, 7 in stage III, 5 in stage IV. The FIGO stage was changed in 10 cases (27.8% : 10/36) after surgery. All ten cases were found in more progressive surgical stage than the FIGO stage. Six of these 10 cases had metastases or invasion to ovaries and tubes. Three of 10 cases had the dissemination in abdominal cavity.
The histological grade and the depth of myometrial invasion correlated with the surgical stage. Patients with the histological grade of G
3 were not in surgical stage I and II, and had few the deep myometrial invasion. Patients with surgical stage IV had no histological grade of G
1, and had deep myometrial invasion.
The five-year survival rate in the surgical stage was 87.1% in stage I, 57.1% in stage II, 44.5% in stage III, and 0.0% in stage IV. The histological grade and the depth of myometrial invasion had correlation with the five-year survival rate. The histological grade was more correlativility than the myometrial invasion in survival rate. Patients with the histological grade of G
1 had 100% of the five-year survival rate.
In cases of surgical stage II or more, no postoperative treatments had a good response. In 9 cases treated by the postoperative chemotherapy, the five-year survival rate was 0.0%.
In conclusion, (1) the FIGO clinical stage was changed in 27.8% after surgery, (2) survival rate was correlated with the histological grade, (3) the postoperative chemotherapy was not successful for advanced endometrial cancer in stage II or more. The most important treatment of endometrial cancer is in the operation, and the method of operation should be selected by the surgical stage.
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