OBJECTIVE To examine the necessity and sufficiency of different types of hysterectomy for the surgical treatment of endometrial cancer. METHODS This was a multicenter collaborative study conducted by 11 institutions. Among patients with stage I-III endometrial cancer who underwent surgery as the initial treatment (only chemotherapy was provided if adjuvant therapy was needed) from 2001 to 2012, we retrospectively examined the type of hysterectomy, clinicopathological factors, recurrence rate over a maximum period of 5 years, and the site of recurrence. The local recurrence rate was examined by univariate and multivariate analyses. RESULTS Among 1335 patients, 982 (73.6%) underwent simple hysterectomy (SH) and 353 (26.4%) underwent modified radical hysterectomy (mRH) and were observed for a mean duration of 51.8 months. No significant difference was observed in the rate of local recurrence between the SH and mRH groups (p = 0.928). In multivariate analysis, clinicopathological factors independently associated with localized recurrence included postmenopausal status [hazard ratio (HR) 5.036, 95% confidence interval (CI) 1.506-16.841, p = 0.009], with stages II (HR 3.337, 95% CI 1.701-6.547, p < 0.001) and III (HR 2.445, 95% CI 1.280-4.668, p = 0.007), vs stage I and histological type 2 (HR 1.610, 95% CI 0.938-2.762, p = 0.001). CONCLUSIONS For endometrial cancer patients requiring surgery, the selection of a more extensive type of hysterectomy did not reduce the rate of local recurrence. Therefore, there is little significance in performing mRH in such cases.

中文翻译：

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子宫切除术类型的扩展是否有助于子宫内膜癌的局部控制？

目的探讨不同类型子宫切除术治疗子宫内膜癌的必要性和充分性。方法 这是一项由 11 个机构进行的多中心合作研究。我们回顾性分析2001年至2012年以手术为初始治疗（需要辅助治疗时仅进行化疗）的I-III期子宫内膜癌患者的子宫切除类型、临床病理因素、最长周期内的复发率。 5年，及复发部位。通过单变量和多变量分析检查局部复发率。结果 在 1335 例患者中，982 例（73.6%）接受了单纯子宫切除术（SH），353 例（26.4%）接受了改良根治性子宫切除术（mRH），平均观察时间为 51.8 个月。SH 组和 mRH 组之间的局部复发率没有显着差异 (p = 0.928)。在多变量分析中，与局部复发独立相关的临床病理因素包括绝经后状态[风险比 (HR) 5.036，95% 置信区间 (CI) 1.506-16.841，p = 0.009]，II 期（HR 3.337，95% CI 1.701- 6.547，p < 0.001）和 III 期（HR 2.445，95% CI 1.280-4.668，p = 0.007），对比 I 期和组织学类型 2（HR 1.610，95% CI 0.938-2.762，p = 0.001）。结论对于需要手术的子宫内膜癌患者，选择更广泛的子宫切除术并不能降低局部复发率。因此，在这种情况下进行 mRH 意义不大。