| Uterine sarcoma accounted for about 1%of all female genital tract malignant tumor,uterine body 3%-7%of malignant tumor.Because of its rare and histopathological diversity,there is still lack of the best treatment plan and the consensus of the risk factors associated with poor prognosis.But due to its complex pathological type,and prognosis factors is not very clear,improve the patients treated by case analysis can help to explore the clinical characteristics and prognosis of uterine sarcoma related factors,and to provide data for clinical diagnosis and treatment,in order to improve the survival rate.Objective:Uterine sarcoma is a disease that seriously harms women’s health and reduces their living time.Due to its rarity,high degree of malignancy and histopathological diversity,there is still a lack of consensus on optimal treatment options and risk factors associated with poor prognosis.Due to its complex pathological type,and prognosis factors is not very clear,improve the patients treated by case analysis can help to explore the clinical characteristics and prognosis of uterine sarcoma related factors,and to provide data for clinical diagnosis and treatment,in order to improve the survival rate.Methods:From January 2010 to July 2016,58 cases of uterine sarcoma were collected from our hospital,and the histological type,clinical features,treatment methods and prognosis were analyzed retrospectively.SPSS 19.0 statistical software was used for statistical analysis.Different histological types of patients with clinical characteristics in this paper,comparing the chi-square analysis,analysis of 58 patients with total 1 year,3 years and 5 years survival rate,to explore the factors influencing the survival of patients with the sample;And by using the Cox proportional hazards model for multiple factors regression analysis,this sample all of the patients with uterine sarcoma menopausal status,age,surgical staging,uterine size,pathological type analysis to explore the various factors influencing the prognosis of uterine sarcoma.Results:1.Take the median age of 54 to group:the group people’s of less 54 years old 1 year,3 years and the 5year survival rate was 75%(24/32),71.40%(15/21),83.3%(14/17),and that of>54 years old group was 53.9%(14/26),37.5%(6/16),37.5%(3/9);Age 1,3 year survival rate differences no present statistical significance(P>0.05),5 years survival rate differences statistically significant(P<0.05),Kaplan Meier-survival analysis:the Log Rank test corresponding to the P value=0.06(P>0.05),said the statistics age is directly related to survival rate of patients with uterine sarcoma.The average age of menopause in our country was 50 years old,and the chi-square test and kaplan-meier survival analysis showed significant difference in survival time between patients aged over 50(P<0.05).2.The survival rate of 1,3 and 5 years in the un-menopausal patients was 100%(19/19),75%(9/12)and 80%(8/10).The survival rate of the postmenopausal patients was 79.5%(31/39),48%(12/25)and 56%(9/16),respectively,for 1 year,3 years and 5 years.There was a statistical significance(P=0.04)for the difference in the 1-year survival rate of the menopausal status(P=0.04),and there was no statistically significant difference between the three years and the 5-year survival rate(P>0.05).Kaplan-meier survival analysis was used to estimate the effect of survival rate,and the results were statistically significant(P<0.05).3.The size of the uterus is less than 2 month of 1 year,3 years,5 years survival rate was 88.9%(24/27),57.9%(11/19),37.5%(6/16),palace of size greater than 2 month 1 year,3 years,5 years survival rate was 90%(27/30),55.6%(10/18),70%(7/10);The difference was not statistically significant(P BBB 0.05)Kaplan-Meier survival analysis was used to estimate the effect of uterine size on survival,and the results were not statistically significant(P>0.05).4.period and Ⅱ,Ⅲ,Ⅳ period 1 year survival rate was 100%(36/36),71.4%(5/7),83.3%(10/12),0%(0/3);Stage and Ⅱ,Ⅲ,Ⅳ 3 year survival rate is respectively:69.6%(16/23),50%(3/6),28.6%(2/7),0%(0/1);Stage and Ⅱ,Ⅲ,Ⅳ patients 5-year survival rate was 76.4%(13/17),50%(2/4),40%(2/5),zero(0);There was a statistical significance(P<0.0001),and the survival rate was not statistically significant in 3 years and 5 years(P>0.05).The Kaplan-Meier estimate surgical staging the impact on the survival rate,survival analysis results are statistically significant(P<0.0001),including Ⅲ,Ⅳ period the median surial in patients with 40 months,10 months,respectively,,Ⅱ period in patients with median surial cannot show.5.Leiomyosarcoma 1 year survival rate was 95%(19/20),93,8%(15/16),endometrial stromal sarcoma mesoderm mixed tumor(carcinosarcoma)72,2%(13/18),inflammatory muscle fiber mother cell sarcoma 0%(0/1),100%adenosarcoma(3/3);3 year survival rate was 500%(5/10),90.9%(10/11),25%(3/12),0%(0/1),100%(3/3);5-year survival rates were 62.5%(5/8),88.g%(8/9),28.6%(2/5),0%(0/1),and 100%(2/2).There was a statistical significance(P value was 0.019,0.0075),and the 5-year survival rate was not statistically significant(P=0.18).Kaplan-Meier survival analysis was used to estimate the effect of survival rate,and the results were statistically significant(P<0.0001).6.Simple surgery,surgery+radiotherapy+chemotherapy,surgery+chemotherapy,surgery+radiotherapy 1 year survival rate:90.3%(28/31),100%(5/5),85%(17/20),100%(2/2);3 year survival rate was 71.4%(15/21),100%(1/1),38.5%(5/13),0%(0/1)(P=0.12).5-year survival rate was 80%(12/15),100%(1/1),44.4%(4/9),and 0(0/1),the different treatments of 1 year,3 years,5 years survival rate has no statistically significant difference(P>0.05),such as table 9.Kaplan-Meier survival analysis was used to estimate the effect of treatment on survival rate,and the results were not statistically significant.7.Postoperative pathology indicated that the survival rate of patients with deep muscle infiltration<1/2 was 1 year,3 years,5 years:74.2%(23/31),70%(14/20),73.30h(11/15);The survival rate of patients with deep muscle infiltration>1/2 was 54.2%(13/24),40%(6/15),and 50%(5/10),respectively,for 1 year,3 years and 5 years.There was no statistically significant difference in the survival rate between 1,3 and 5 years of deep muscular infiltration(P BBB 0.05).Kaplan-Meier survival analysis was used to estimate the effect,of deep muscular infiltration on survival rate,and the results were not statistically significant.8.Postoperative pathology indicated that the survival rate of patients with vascular cancer was 1,3,5 years:70%(28/40),60%(15/25)and 66.7%(12/18).The survival rate of patients with venous cancer thrombosis was 56.3%(9/16),50%(5/10)and 57.1%(4/7).There was no statistically significant difference between the 1-year,3-year and 5-year survival rates of vascular cancer suppository(P BBB 0.05).Kaplan-meier survival analysis was used to estimate the effect of vascular cancer suppository on survival rate,and the results were not statistically significant.9.Postoperative pathology indicated that patients with positive lymph nodes had a 1-year,3-year,5-year survival rate:76.9%(30/39),72.7%(16/22)and 75%(12/16).In patients with negative lymph nodes,the survival rate was 28 in 1 year,3 years and 5 years.5%(4/14),10%(1/10),80%(4/5),the difference in the 1-year and 3-year survival rate of the lymph nodes was statistically significant(P<0.05),and the 5-year survival rate was not statistically significant(P=1).Kaplan-meier survival analysis was used to estimate the effect of lymph node condition on survival rate,and the results were statistically significant(P<0.001).10.The survival rate of patients with postoperative pathological tumor size less than 5cmwas 1 year,3 years and 5 years:67.9%(19/28),38.9%(11/18)and 75%(9/12).Tumor size>5 cm of 1 year,3 years,5 years survival rate was 62.1%(18/29),55.6%(10/18),57.1%(8/14),tumor size is 1 year,3 years,5 years survival rate difference has no statistical significance(P>0.05).If the tumor size was larger than 5cm,kaplan-meier survival analysis was used,and the results were not statistically significant(P>0.05).Kaplan-meier survival analysis was used to estimate the effect of tumor size on survival rate,and the results were statistically significant(P<0.018).Conclusion:Age,menopausal status,surgical staging,pathological type,lymph node is the effect of prognosis of uterine sarcoma,aged>50。Menstruating,middle-late,leiomyosarcoma and carcinosarcoma,presents relatively poor prognosis of patients with positive lymph nodes.The prognosis was relatively good for patients aged 50 or older,menopause,early stage,adenosarcoma and endometrial stromal sarcoma and lymph node negative.Among them,the operative stage and pathological type are independent factors that affect the prognosis. |
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