摘要
目的 :分析子宫肉瘤的临床资料 ,了解其预后因素 ,寻求治疗的改进方法。方法 :回顾性分析复旦大学上海肿瘤医院 1991～ 2 0 0 1年收治的 32例子宫肉瘤的组织学类型、临床特点、治疗方法及预后因素。结果 :总的 3年及 5年生存率分别为 79 2 %和 6 8 4 % ,总复发率为 4 3 8%。手术分期对 3年及 5年生存率差异有显著性 (P <0 0 5 ) ,对复发有明显影响 (P <0 0 1)。绝经前患者 5年生存率为 85 7% ,绝经后的患者 5年生存率为 5 8 2 % (P <0 0 5 )。不同手术方式与 3年及 5年生存率差异无显著性 (P >0 0 5 ) ,但广泛全子宫双附件 +盆腔淋巴结清扫术与其它手术方式对复发的影响差异有显著性 (P <0 0 5 )。结论 :子宫肉瘤的预后与临床和手术病理分期 ,绝经前后有明显关系。子宫肉瘤的盆腔复发率高 ,盆腔淋巴结清扫术虽不一定能改善其 5年生存率 ,但能减少子宫肉瘤的复发。术后加放疗或化疗不能提高其 5年生存率。采用手术加放疗加化疗的综合治疗 ,其对中位复发时间有明显影响 (P <0 0 1) ,其 5年生存率比手术加放疗或加化疗有所提高 ,但无统计学上显著差异 (P>0 0 5 ) 。
Objective:To evaluate the prognostic factors and treatment methods of 32 uterine sarcoma.Methods:32 cases of the uterine sarcoma from Cancer Hospital, Fu Dan University, ShangHai were eligible for this retrospective study.Results:The overall 5-year and 3-year survival rates were 68 4% and 79 2% respectively, the overall recurrence rates was 43 8%. The difference in the 5-year and 3-year survival rates between stage Ⅰ and stage Ⅱ, Ⅲ, Ⅳ was significant (P<0 05), The difference in the recurrence rates between stage Ⅰ and stage Ⅱ, Ⅲ, Ⅳ was significant (P<0 01). Pre-menopausal surviving 5-year accounted for 85 7% and post-menopausal 58 2% (P<0 05). The difference in the 5-year and 3-year survival rates between the different surgery treatments was not significant (P>0 05), but the difference in the recurrence rates between extensive abdominal hysterectomy and bilateral pelvic lymphadenectomy and the different surgery treatments else was significant (P<0 05).Conclusion:The prognosis of uterine sarcoma is significantly associated with clinical and surgical-pathological stage and pre-or post-menopausal status. The pelvic recurrence rates of uterine sarcoma are high. Extensive abdominal hysterectomy and bilateral pelvic lymphadenectomy cannot raise 5-year survival rates, but can decrease recurrence rates. Post-surgical adjuvant radiotherapy or chemotherapy cannot raise 5-year survival rates. A combination of surgery, radiotherapy and chemotherapy can raise median of recurrence time (P<0 01), and can raise 5-year survival rates, but was not significant (P>0 05), and requires further evaluation.
出处
《临床肿瘤学杂志》
CAS
2004年第1期48-51,共4页
Chinese Clinical Oncology
