臨床婦人科産科61巻2号

2007年02月発行

今月の臨床 子宮体癌の最新知見─専門医のために

再発子宮体癌の取り扱い

著者： 市川義一¹ 進伸幸¹ 青木大輔¹

所属機関： ¹慶應義塾大学医学部産婦人科

ページ範囲：P.152 - P.157

はじめに

　子宮体癌は不正出血を早期から認め，I期・II期という早期に診断される症例の占める割合が高いので，子宮体癌全体としてみた場合，ほかの婦人科癌と比べると比較的予後の良好な疾患とみられることがある．しかし，進行癌を含めた子宮体癌の5年累積生存率は，Ia期 : 88.9％，Ib期 : 90.0％，Ic期 : 80.7％，IIa期 : 79.9％，IIb期 : 72.3％，IIIa期 : 63.4％，IIIb期 : 38.8％，IIIc期 : 51.1％，IVa期 : 19.9％，IVb期 : 17.2％1）とIII期・IV期では明らかに予後不良であり，進行子宮体癌では高率に再発を経験する．また，1975年～2004年の当院での成績では，早期子宮体癌に限っても，5年時においてIa期 : 1.47％，Ib期 : 5.39％，Ic期 : 11.9％，IIa期 : 12.8％，IIb期 : 25.6％の再発を認めている．

　このような背景のもと，現在まで再発子宮体癌に対する明確な治療指針はなく，個々の症例において治療方針が検討，決定されているのが実情である．

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