Objective: To determine the influence of different surgical procedure on post-operative survival rate and recurrence of stage I endometrial carcinoma.
Methods: From 1986 to 1996, 110 patients with stage I endometrial carcinoma surgically treated in our hospital were studied retrospectively. They were divided into three groups, including total hysterectomy plus bilateral salpingo-oophorectomy (group A), radical or modified radical hysterectomy (group B) and total hysterectomy plus bilateral salpingo-oophorectomy or radical hysterectomy or modified radical hysterectomy + pelvic lymphadenectomy (group C). Survival and recurrent rates were analysed according to the follow-up data.
Results: Five-year survival rate of the three groups are 89.5%, 90.5% and 95.1% respectively (P > 0.05). Of the 71 cases followed up for more than two years, 9 relapsed. The recurrent rates were 12.7%. Seven relapsed within three years after operation. Eight patients had local recurrence and 5 had distant metastasis. Recurrent rates of three groups are 13.9%, 9.1% and 12.5% (P > 0.05), local recurrent rates are 13.9%, 9.1% and 8.3% (P > 0.05), distant metastasis rates are 2.8%, 9.1% and 12.5% respectively (P > 0.05) with no statistical significance.
Conclusions: Surgical method is not the main factor influenced the survive of stage I endometrial carcinoma. Radical operation or lymphadenectomy will not increase the survival rate of stage I endometrial carcinoma significantly. The purpose of such operation is to find out the exact stage and the possible prognosis. Distant metastasis is remarkable, and should be considered in the adjuvant therapy.