CAJ | 학술논문

美国国立综合癌症网络(NCCN) 2015年子宫肿瘤临床实践指南沿用国际妇产科联盟(FIGO) 2009分期标准.除了有生育要求或无法耐受手术的患者,子宫内膜癌患者的首选治疗方案仍为手术.根据肿瘤累及范围,将子宫内膜腺癌分为三类以进行术前评估:病变局限于子宫体内,病变侵犯宫颈,病变超出子宫外.新指南提出,对于满足一定条件的育龄期子宫内膜癌早期患者可使用持续孕激素治疗以保留生育功能.另外,新指南首次提出,对于怀疑肿瘤扩散到子宫外的患者,可考虑术前新辅助化疗.患者术后辅助治疗均应根据病理结果以及高危因素进行选择.新指南明确提出的高危因素包括:年龄＞ 60岁、淋巴管间隙受侵、肿瘤直径≥2 cm、子宫体下段及宫颈黏膜腺体受侵.且术后的放疗应当在阴道断端愈合后尽早施行,不超过术后12周.
미국국립종합암증망락(NCCN) 2015년자궁종류림상실천지남연용국제부산과련맹(FIGO) 2009분기표준.제료유생육요구혹무법내수수술적환자,자궁내막암환자적수선치료방안잉위수술.근거종류루급범위,장자궁내막선암분위삼류이진행술전평고:병변국한우자궁체내,병변침범궁경,병변초출자궁외.신지남제출,대우만족일정조건적육령기자궁내막암조기환자가사용지속잉격소치료이보류생육공능.령외,신지남수차제출,대우부의종류확산도자궁외적환자,가고필술전신보조화료.환자술후보조치료균응근거병리결과이급고위인소진행선택.신지남명학제출적고위인소포괄:년령＞ 60세、림파관간극수침、종류직경≥2 cm、자궁체하단급궁경점막선체수침.차술후적방료응당재음도단단유합후진조시행,불초과술후12주.
Version 2015 of the National Comprehensive Cancer Network (NCCN) Guidelines for Uterine Neoplasms uses the 2009 International Federation of Gynecology and Obstetrics (FIGO) staging system.These NCCN guidelines divide pure endnmetrioid cancers into three categories to delineate treatment:(1) disease limited to the uterus;(2) cervical involvement;(3) extrauterinc disease.Surgery is recommended for medically operable patients.Continuous progestin-based therapy may be considered for highly selected patients with stage IA disease who wish to preserve their fertility.Preoperative chemotherapy can be considered if extrauterine disease is suspected.Factors that may influence the decision regarding adjuvant therapy include lymph vascular space invasion (LVSI),patient age,tumor volume,and lower uterine segment or surface cervical glandular involvement.When administering adjuvant radiotherapy,it should be initiated as soon as the vaginal cuff has healed,no later than 12 weeks after surgery.