Clinical Analysis Of Uterine Sarcoma In 10 Cases And Review Of The Literature

Objective:To evaluate the epidemiology, diagnosis, treatment methods and prognostic factors in uterine sarcoma.Methods:Reviewing medical records of ten cases at our hospital over a period of 20 years and combinating with reported literature at home and abroad. According to histological types of uterine sarcoma, there are 6 cases of uterine leiomyosarcoma,3 cases of malignant mullerian tumor and 1 case of endometrial stromal sarcoma in this group. According to the 1988 FIGO surgical staging of endometrial cancer standards,6 cases of stageâ… ,1 case of stageâ…¡and 2 cases of stageâ…£were confirmed after surgery,8 cases of which were diagnosed in our hospital. Surgical treatment was chose by 9 patients.8 patients had detailed record during the surgical procedure in our hospital. Doxorubicin, cyclophosphamide, VP16, cisplatin and paclitaxel were used in this group after surgery as adjuvant chemotherapy, such as TP, PAC, VAC and thiotepa. Meanwhile, one patient received additionally postoperative radiotherapy.Results:1. Incidence of this group of patients age ranged 27 years to 78 years with an average age of 52.4 years, which had 2 cases below 35 years.2. There were 8 cases with irregular vaginal bleeding,1 case with abdominal mass and 1 case with smelly vaginal discharge.8 patients can found increased uterines and pelvic mass by gynecological examination.3. CA125 detection of four patients with one case elevated, who associated with bilateral ovarian cancer. Gynecological ultrasound suggested abnormality of uterus in 5 patients. Meantime, there were 2 cases combining with the resistance index that was less than 0.4 in Doppler ultrasound.4.5 patients experience preoperative C&D, of which 4 cases diagnosed or tipped uterine sarcoma.4 cases were confirmed by paraffin pathology after surgery including 2 cases of uterine leiomyosarcoma. Finally,1 patient gave up treatment.5.8 patients were misdiagnosed before surgery, of which 6 cases were treated as uterine myoma,1 case as ovarian tumor and 1 case as uterine endometrial cancer.6.7 cases were followed up, of which 2 patients died for 1 year and 1 case had survived for 5 years.Conclusions:1. uterine sarcomas usually occur in middle-aged women, which lack of specially clinical manifestation and diagnosis methods. Consequently, there is a high level of misdiagnosis rate.2. The surgical treatment is still the primary means for uterine sarcoma, which may has not significant correlation with patient's prognosis.3. The prognosis of patients with uterine sarcoma is poor, so the earlier diagnosis and individually effective treatment should be recommended.