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中华妇幼临床医学杂志(电子版) ›› 2025, Vol. 21 ›› Issue (05) : 508 -515. doi: 10.3877/cma.j.issn.1673-5250.2025.05.003

标准·方案·指南

《老年子宫内膜癌手术治疗中国专家共识(2024年版)》解读
薛绍龙, 杨博文, 郄明蓉()   
  1. 四川大学华西第二医院妇科、出生缺陷与相关妇儿疾病教育部重点实验室,成都 610041
  • 收稿日期:2025-07-26 修回日期:2025-09-11 出版日期:2025-10-01
  • 通信作者: 郄明蓉

Interpretation of the Chinese Expert Consensus on Surgical Treatment of Endometrial Cancer in the Elderly (2024 Edition)

Shaolong Xue, Bowen Yang, Mingrong Xi()   

  1. Department of Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2025-07-26 Revised:2025-09-11 Published:2025-10-01
  • Corresponding author: Mingrong Xi
  • Supported by:
    Science and Technology Planning Project of Science and Technology Department of Sichuan Province(2024NSFC1875)
引用本文:

薛绍龙, 杨博文, 郄明蓉. 《老年子宫内膜癌手术治疗中国专家共识(2024年版)》解读[J/OL]. 中华妇幼临床医学杂志(电子版), 2025, 21(05): 508-515.

Shaolong Xue, Bowen Yang, Mingrong Xi. Interpretation of the Chinese Expert Consensus on Surgical Treatment of Endometrial Cancer in the Elderly (2024 Edition)[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(05): 508-515.

子宫内膜癌(EC)是常见的妇科恶性肿瘤之一,在我国妇科恶性肿瘤中发病率居第2位,导致的患者死亡率位列妇科恶性肿瘤第3位。《老年子宫内膜癌手术治疗中国专家共识(2024年版)[Chinese Expert Consensus on Surgical Treatment of Endometrial Cancer in the Elderly (2024 Edition)]》(以下将其简称为《本共识》)提出,若通过综合评估老年EC患者身体功能状态及肿瘤可切除性优化手术决策,强调术前调整患者的衰弱与共病状况,术中优化麻醉策略与手术协作,术后实施加速康复外科(ERAS)方案、营养支持及并发症预防,则可降低老年EC患者的围术期风险。《本共识》定义的老年EC患者为年龄≥65岁者。《本共识》为老年EC患者的规范化治疗提供了科学依据与实践指南。笔者拟就《本共识》关键推荐意见与证据依据进行系统解读,包括老年EC患者的临床特点、预后及手术治疗价值,老年EC患者围术期综合管理策略等,旨在帮助临床医师准确理解《本共识》的核心内容,促进其对《本共识》的规范化临床应用。

Endometrial cancer (EC) remains one of the most prevalent gynecologic malignancies, ranking second in incidence and third in mortality among gynecologic cancers in China. The Chinese Expert Consensus on Surgical Treatment of Endometrial Cancer in the Elderly (2024 Edition) (hereinafter referred to as " the Consensus" ) outlines evidence-based recommendations for optimizing surgical management in elderly patients with EC. It proposes that comprehensive assessment of physical function and tumor resectability, preoperative optimization of frailty and comorbidities, individualized anesthesia strategies, and enhanced perioperative care, which including enhanced recovery after surgery (ERAS) nutritional support and complication prevention, may contribute to improved outcomes. In the Consensus, elderly EC is defined as disease occurring in individuals aged ≥65 years. The Consensus serves as a reference for the standardization of surgical treatment and perioperative management in this population. This article reviews and interprets the key recommendations presented in the Consensus, focusing on the clinical characteristics, prognosis, and surgical management of elderly EC, as well as comprehensive perioperative care strategies, to support clinicians in understanding and applying these recommendations in clinical practice.

表1 《本共识》对推荐意见的推荐级别及代表意义
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