Prognostisch relevante Faktoren beim malignen Müllerschen Mischtumor

Abstract

In a retrospective analysis of 429 endometrial carcinoma and 29 malignant mixed Müllerian tumour (MMMT) patients, the prognostic factors were evaluated. More than 80% of endometrial carcinomata were staged as I or II, whereas about 30% of MMMT's already in stage III or IV (p less than 0.05). MMMT patients were 10 years older than the carcinoma group (73a vs 63a; p less than 0.001). The risk factors parity, adipositas, and diabetes were equally distributed in the two groups, the survival was worse in MMMT (p less than 0.0001). Applying univariate analysis stage, grading, myometrial invasion and type of therapy significantly affected the survival of endometrial carcinoma patients. After a Cox regression, only stage and grading remained significantly associated with the prognosis. For MMMT's, the survival was also influenced by stage, myometrial invasion, and kind of therapy. Moreover, the parity was found to affect markedly the course of disease. Cox regression of our data excluded all but stage and parity. The beneficial influence of parity on the prognosis of MMMTs, despite a latency of more than 20 years from the last birth to tumour appearance, is unique in oncology.

Poorer survival of nulliparous women with endometrial carcinoma

“…The highly significant difference in survival for the nulliparous compared with the parous women, but no further improvement of survival with deliveries beyond the first, could indicate that a protective effect of each pregnancy is less important than not having delivered when it comes to prognosis. In a small study of 29 patients with mixed müllerian tumors, nulliparity was found to be associated with poor prognosis 22. Wagenius et al23 did not observe any prognostic influence of parity in a study of endometrial carcinoma patients.…”

Sonomorphologische Beurteilung des postmenopausalen Endometriums

“…Da bei niedrigem Stadium gute Behand lungserfolge erzielt werden können [1] [5,6] [7] wurde die Grenze ebenfalls bei einer Endometriumdicke von 8 mm gesetzt und eine Sen kung der Rate an nachfolgenden Abrasiones zur histologi schen Abklärungum 50% beschrieben. Zwar bedeutet das Heraufsetzen des Grenzwertes eine Verbesserung der Spezifität, aber die Sensitivität sinkt dadurch, wie wir anhand der Summenhäufigkeitskurven demonstrieren konnten, deutlich ab (Abb.…”