目的：探討早期子宮內膜癌手術與手術合併放射治療的存活率及各種預後因子。材料與方法：我們將 1984 年 6 月至 1996 年 7 月間在馬偕醫院接受治療的 143 位早期子宮內膜癌的病患做回溯性的研究，並且再根據 FIGO 分期系統重新分期，乳突狀漿液癌和透明細胞癌都排除討論，共計 135 位病患進入本研究之分析。 如果患者具有下列一項以上危險因子，則視為高危險群，否則視為低危險群。這些危險因子包括子宮肌層被侵犯深度大於二分一細胞分化第 3 級（ G3 ）子宮頸侵犯腺鱗癌。 在這 135 位病患中 A 組有 99 位病患接受手術治療，其中 8 位病患（ 8% ）為高危險群， B 組有 36 位病患接受手術合併放射線治療，其中 30 位病患（ 83% ）為高危險群。 在手術治療上，大部分的病患接受子宮及兩側輸卵管卵巢切除術， 36 位接受放射線治療的病患，大部份接受手術後骨盆外照射或配合陰道殘端腔內治療，其骨盆外照射總劑量為 4000 - 5400 厘葛雷（ cGy ）（平均為 5013 厘葛雷）， 至於陰道殘端腔內治療， 每次劑量為至黏膜下 0.5 公分處給予500 厘葛雷， 總劑量為 1000 - 3000 厘葛雷（平均為 2933 厘葛雷）。 結果： 經過 6 -147 個月追蹤（中位數為 62 ），五年整體存活率 A 組為 96.9%，B 組為 89.3%。 經由單變數因子分析臨床上影響存活因素以年齡大於 55 歲、子宮肌肉層侵犯程度大於二分之一及停經為存活率降低之重要預後因子，而多變數因子分析上，子宮肌肉層侵犯程度大於二分之一為存活率降低之重要預後因子，而其他因子則皆無統計學上的意義。 在 A 組 99 位病患中有 2 位復發，其五年局部控制率為 98%； 在 B 組 36 位病患中有 4 位復發，其五年局部控制率為 88%。結論：在經過我們回朔性的研究顯示，對於早期子宮內膜癌的治療上，選擇性對於高危險群的病患，給予手術合併放射線治療，臨床上有令人滿意的效果及發現重要預後因子，值得做為進一步前瞻性研究的參考。

　　　　　Aims:To evaluation prognostic factors and treatment outcome for earlystage endometrial cancer patients treated with surgery or combined surgery andradiation therapy(RT).Material and Methods:We designed a retrospective study for 143 patients withStage I/II endometrial cancer treated at Mackay Memorial Hospital between 1984and 1996. Patients were restaged according to the 1988 FIGO staging system.Patients with papillary serous, and clear cell histologies were excluded.Patients were considered as high risk group if they had one or more of thefollowing factors: grade 3 tumor differentiation, depth of myometrial invasion>1/2, pathologic cervical involvement, or adenosquamous histology. Of these 135patients, 99 patients was treated with surgery alone(Group A)and the other 36patients were treated with combined surgery and RT(Group B). Eight (8%) patientsin group A and thirty (82%) patients in group B were defined high risk group.The main treatment modality consisted of total abdominal hysterectomy andbilateral salpingo-oophorectomy and /or postoperative external pelvic RTwith/without intracavitary brachytherapy. The total dose of external pelvicirradiation is 4000-5400 cGy(median: 5013 cGy). Intracavity brachytherapy wasgiven with 500 cGy per fraction prescribed to a depth of 0.5 cm under mucosalsurface and the total dose was 1000-3000 cGy(median:2933 cGy).Results:Follow -up duration ranged from 6 to 147 months (median:62 months). The5-year overall survival rate in group A and group B were 96.9% and 89.3%,respectively. Univariate analysis identified the following significantprognostic factors:age, menopausal status and myometrial invasion. Multivariateanalysis revealed myometrial invasion more than half of the thickness to be theonly factor significant for reduce overall survival. Two of the 99 patients ofgroup A had tumor relapse. The local control rate is 98%. Four of the 36patients of group B had tumor relapse. The local control rate is 88%.Conclusion: Our retrospective study revealed good outcome associated withselective treatment combing surgery and RT for high risk patients. We also confirmedsome important prognostic factors associated with survival. Base on the resultsof our study, further prospective study for the role of adjuvant radiationtherapy for early stage endometrial cancer patient can be designed.