| Objective: The etiology of uterine sarcoma is unknown now, its early diagnosis is difficult and it is easy to recur, the pathological types are many, each pathological types of clinical situation is different, the sensitivity of auxiliary examination is different, it is easy for uterine sarcoma to form part recurrence and transfer to distant place in the early period .Methods: To retrospective analysis 21 uterine sarcomas from March, 1998 to March, 2005 in Dalian Medical University affiliated first hospital. All patients of uterine sarcoma were confirmed by pathology. The standard of clinical stage of International Union of Counter Cancer(IUCC) was adopted in the paper, among which there were 6 cases with stageâ… , 3 cases with stageâ…¡, 8 cases with stageâ…¢, 4 cases with stageâ…£. According to histology categorization of American anticancer association, there were 10 cases with leiomyosarcoma, 4 cases with endometrial stromal sarcomas and 7 cases with malignant mullerian mixed tumor. Of them 7 cases were premenopause and 14 cases were post menopause. All of 21 pations were followed up (The survival time was calculated from the date of surgery or the data of preliminary diagnosis to the last one of following up or the date of death). The SPSS10.0 statistics software package was used to carry on the statistical analysis, t test was used.Results : 1. The clinical symptom of uterine sarcoma showed as abnormal vaginal bleeding (61.91%), as palpable mass of lower abdomen (42.86%), as pain on lower abdomen (38.10%) and as vaginal discharge (19.05%). 2. The predominant sign was uterus enlarged at different levels (95.20%), among this, 76.19% is bigger than like 3-month pregnancy. 3. 5 cases underwent diagnostic uterine scrape and 2 of them were diagnosed suffering from uterine sarcoma before operation, 1 case had shifted all over the body, which was final diagnosed by abdomen prick. 4. There were many different nodus in the uterus, the diameters of nodus were from 0.5 cm to 7cm. 2 cases of all were invasived to cavitas pelvis tissue, and a few lymphaticus noduses became bigger. 5. Sample displayed during operation showed fish-flesh-like, gray-yellow or yellow-red intervals and 4 cases were diagnosed suffering from uterine sarcoma by frozen slice. 6. Besides 1 cases shifted all over the body, 20 cases were treated by operation. Among of them, 12 cases accepted entire uterus and double adnexectomy, 4 cases accepted extensive abdominal hysterectomy and bilateral pelvic lymphaectomy, 2 cases accepted abdominal hysterectomy and bilateral pelvic lymphaectomy and epiploica, 2 cases accepted cytoreductive surgery, 11 cases added post-operation chemotherapy, it was inequality course of treatment from 1 to 5, used chemotherapy scheme for PC, PA and so on, 3 cases refused post-operation chemotherapy, 2 cases added post-operation radiation therapy. 7. All cases were followed up. Total 1-and 3-year survival rate was 71.43% and 33.33%. Through statistical analysis, it showed that the prognosis of premenopause patients was better than the post-menopause patients. The earlier of clinic staging of uterine sarcoma was, the better of the prognosis was compared with different pathological types, the prognosis of malignant mixed mullerian tumor was the worst, the endometrial stormal sarcoma was worse, and the leiomyosarcoma was the best.Conclusion: 1. The clinical symptom of uterine sarcoma is not particularly, mainly abnormal vagina bleeding, by means of the color ultra, gynecological examination, diagnosis curettage and so on to elevate early diagnose rate. 2. Intraoperative frozen section examination is profitable for doing suitable operation. 3. The prognosis of premenopause and the earlier period of clinic staging is better. 4. Compared with different pathological types, the prognosis of malignant mixed mullerian tumor is the worst, the endometrial stormal sarcoma is worse, the leiomyosarcoma is the better. |
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