摘要
目的:探讨子宫肉瘤的临床特点,了解其预后因素,寻求治疗的改进方法。方法:回顾性分析该院1990年7月～2000年4月收治的32例子宫肉瘤的病理学类型、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79.17%和68.42%,总复发率为43.75%。临床和手术病理分期对3年及5年生存率差异有显著性(P<0.05),Ⅰ期患者与Ⅱ期、Ⅲ期、Ⅳ期的生存率相比有显著性差异,其复发率有明显影响(P<0.01)。绝经前后对3年及5年生存率差异有显著性(P<0.05,P<0.01)。不同手术方式对3年及5年生存率差异无显著性(P>0.05),但广泛全子宫双附件加盆腔淋巴结清扫术对复发率的影响差异有显著性(P<0.05)。结论:子宫肉瘤的临床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较高,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<0.01),其5年生存率比手术加放疗或加化疗有所提高,但无统计学上显著性差异(P>0.05),尚需积累更多经验。
Objective:By exploring the clinical features of uterine sarcoma and investigating its prognostic factors to find the improvement methods for treatment.Methods:The pathological types, clinical feature, treatment methods and prognostic factors of 32 cases of patients with uterine sarcoma admitted in this hospital from July 1990 to April 2000 were analyzed retrospectively.Results:Total 3- and 5-year survival rate of was 79.17% and 68.42%, respectively; total recurrence rate was 43.75%. There was significant difference in clinical and operative pathological grading between 3-year and 5-year survival rate (P<0.05), and there was significant difference among survival rates of stageⅠ,Ⅱ,Ⅲ and Ⅳ (P<0.01).There was significant difference in 3-year and 5-year survival rate between pre-menopause and post-menopause (P<0.05,P<0.01). There was no significant difference in 3-year and 5-year survival rate among different operative methods (P>0.05), but there was significant difference in recurrence rate of extensive abdominal hysterectomy and bilateral pelvic lymphaectomy (P<0.05).Conclusion:The clinical prognosis of uterine sarcoma was obviously related to clinical and pathological grading and pre- and post-menopause.As the higher pelvic recurrence rate of uterine sarcoma, pelvic lymphaectomy could not improve the 5-year survival rate, but could reduce the recurrence of uterine sarcoma. Post-operational adjuvant radiotherapy or chemotherapy could not enhance 5-year survival rate. The integrative therapy with surgery, radiotherapy and chemotherapy played a significant role in median of recurrence time (P<0.01), and 5-year survival rate of which higher than that of operative adjuvant radiotherapy or chemotherapy but without significant difference (P>0.05).
出处
《中国妇幼保健》
CAS
北大核心
2005年第9期1065-1068,共4页
Maternal and Child Health Care of China
关键词
子宫肉瘤
治疗
预后
Uterine sarcoma
Treatment
Prognosis
