The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

doi:10.21203/rs.3.rs-34442/v1

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The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

https://doi.org/10.21203/rs.3.rs-34442/v1

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Objective : The purpose of this study was to explore the necessity of radical hysterectomy (RH) for patients with pure endometrial carcinoma（PEC) combined with cervical involvement by comparing with total hysterectomy (TH).

Methods : A total of 162 patients who were diagnosed as PEC combined with cervical involvement of stage II and III by postoperative pathological examination between January, 2007 and December, 2017 were included in our study. Among of them, 91 were followed up till the end of this study and 71 were lost in the follow-up. In the 91 patients with complete follow-up information, 34 patients were treated with TH and 57 patients were treated with RH. The 5-year progression free survival rate, 5-year overall survival rate, recurrence rate and postoperative complications of patients were evaluated.

Results : There were no significant differences in both the overall survival curve and progression free survival curve between patients with PEC receiving RH and those receiving TH (both p > 0.05). The analysis of postoperative complications showed that patients with RH treatment may have a higher probability of postoperative lymphocyst and urinary dysfunction.

Conclusions : RH may not improve the prognosis of cervical involvement in patients with PEC. The postoperative complications of patients with PEC who treated with RH may increase.

Oncology

Cancer Biology

radical hysterectomy

total hysterectomy

pure endometrial carcinoma

cervical involvement

Table 1. Baseline characteristics

Factors	TH group	RH group	P-values
CASES	34	57	/
AGE			/
MENOPAUSE
YES	22	25	0.055
NO	12	32
MENOPAUSE AGE	53 (52-60)	55 (44-60)	/
SYMPTOMS			/
VAGINAL BLEEDING AFTER MENOPAUSE	19	19
IRREGULAR VAGINAL BLEEDING	6	21
PEIVIC MASS	1	1
DYSMENORRHEA	3	3
OTHERS	4	13
STAGE			0.295
II	29	44
III	5	13
GRADE			0.473
G1	21	27
G2	9	21
G3	4	7
UNKNOW	/	2
CHEMOTHERAPY			0.22
YES	15	30
NO	19	27
RADIOTHERAPY			0.126
YES	17	35
NO	16	21
UNKNOWN	1	1
FELLOW-UP(MONTHS)	37 (8-112)	35 (5-122)	/

Table 2. risk factors for death

	1	2	3	4	5	Rate
Grade	○	○	●	○	●	2/5
MI	●	●	●	○	●	4/5
Serosa invasion	○	●	○	○	○	1/5
Ovary invasion	○	○	○	○	○	0
Fallopian tube invasion	○	○	○	○	○	0
Vagina invasion	○	/	○	○	/	/
Parametrial invasion	○	/	○	○	/	/
Pelvic lymph nodes invasion	○	●	●	○	○	2/5
Paraaortic lymph nodes invasion	○	○	○	○	○	0
LVSI	●	●	●	○	○	3/5
Chemotherapy	●	○	●	○	○	2/5
Radiotherapy	○	○	○	○	○	0

Table 3. Post surgery complications of patients

Complications	Surgery type
Complications	TH (n = 34)	RH (n = 57)
Lymphocyst	10	15
Infection	0	0
Hydronephrosis	1	1
Urinary incontinence	1	6
Dysuria	0	5
Venous thrombus	0	2

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The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

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