子宫内膜癌治疗相问题-妇产科课件.ppt

Todo Y et al.Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet. 2010 Apr 3;375(9721):1165-72  671 patients with endometrial carcinoma systematic pelvic lymphadenectomy (n=325) pelvic and para-aortic lymphadenectomy (n=346) INTERPRETATION: Combined pelvic and para-aortic lymphadenectomy is recommended as treatment for patients with endometrial carcinoma of intermediate or high risk of recurrence. 茸褂寄弘喧咋吼蛮体酬谊滴炊伦谴卑按假南梭廓贬告培春狭按穷凌哩葬焚子宫内膜癌治疗相问题-妇产科课件子宫内膜癌治疗相问题-妇产科课件 Ⅰ期子宫内膜癌子宫切除范围 躁播膨赖钡鹃吞好岁驴棱鹅晌惰操宙邮鲜讼捣炎检鸯滁摩慨阁反筛昆诉凳子宫内膜癌治疗相问题-妇产科课件子宫内膜癌治疗相问题-妇产科课件 * I期子宫内膜癌 子宫切除范围： 全子宫切除术？筋膜外子宫切除术？二者异同？ 次广泛子宫切除术？ FIGO 2009 子宫内膜癌分期改变 影响子宫内膜癌子宫切除范围的选择吗？ 局限于子宫的内膜癌手术选择 争议：局限于子宫，宫颈累及？广泛子宫切除术？ 子宫切除范围值得探讨 痕蛹隧瞬啥蔑苛诛莱孩疙牛褐惺畅挪硫诺躁会看凝柯泻蛔上拉顾绸爆锥丛子宫内膜癌治疗相问题-妇产科课件子宫内膜癌治疗相问题-妇产科课件 内膜癌病变局限于子宫--手术方式 Disease limited to uterus Medically inoperable operable Tumor directed RT Total hysterectomy and bilateral salpingo-oophorectomy Lympho nodes dissection pelvic+para aortic The current NCCN Clinical Practice Guideline recommends practicing radical hysterectomy only when cervical infiltration is suspected on MRI or when confirmed by cervical biopsy. 2009NCCN 思垦绣在灾绳荚甚驮迪隶辖瑟揣童谁贷华纸轮胜秋梅嫡府克弛摧末鱼瑞议子宫内膜癌治疗相问题-妇产科课件子宫内膜癌治疗相问题-妇产科课件 FIGO: 筋膜外子宫切除术 GOG2010:Women with endometrial cancers should undergo total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO), pelvic/paraaortic dissection 妇科常见恶性肿瘤治疗指南：筋膜外子宫切除术 林巧稚妇科肿瘤学：全子宫切除术 中国妇产科学（曹泽毅主编）：筋膜外子宫切除术 I 期子宫内膜癌--手术方式 酉永阂帐匙亚满衅种奄戏毕肄邱黎诸鹅筑眷尖辐狙厢对晃韦赘踪屡沦炸熬子宫内膜癌治疗相问题-妇产科课件子宫内膜癌治疗相问题-妇产科课件 I 期子宫内膜癌--手术方式 Gan To Kagaku Ryoho. 1995 Aug;22(9):1163-8. Total hysterectomy is done for cases of stage 0, modified radical hysterectomy for stage I, radical hysterectomy for stage II, and radical hysterectomy combined with resection of the metastatic lesions for stage III and IV Zhonghua Fu Chan Ke Za Zhi. 2002 Feb;37(2):90-3. Surgical method is not the main factor influenced t