Clinical Analysis Of56Cases Of Uterine Sarcoma

Objective:To investigate the clinical characteristics, diagnosis,treatment and prognosis of uterine sarcoma.Methods:56cases of the uterine sarcomas who were treated at the Women’s Hospital School of Medicine Zhejiang University between June in2006and June in2008,among which there were30cases with stage Ⅰ,9with stage Ⅱ,11with stage Ⅲ,6with stage Ⅳ.Results:The average age of onset with the different histological type of the tumor was significant different, the average age of the malignant mullerian mixed tumor was64.64±6.34, compared with the average age of the leiomyosarcoma52.64±7.67and endometrial stromal sarcomas53.08±9.87, there was significant different(P<0.05). The patients usually manifested with abnormal vaginal bleeding36/56(64.3%), pain on lower abdomen21/56(37.5%),vaginal discharge13/56(23.2%), palpable mass of lower abdomen16/56(28.6%), symptoms of oppression11/56(19.6%) and tumor cachexia7/56(12.5%). According to the different histological types, though the preoperative diagnostic curettage or cervix neoplasm biopsy for the pathological examination-the diagnostic rate of different histologic types was significantly different, the pathological diagnosis rate of the leiomyosarcoma was lower9/17(52.9%), when compared with the endometrial stromalsarcomas9/10(90%) and malignant mullerian mixed tumor8/9(88.9%), with significant different (P<0.05). Combining with the history, gynecologic examination and auxiliary examination, preoperative diagnosis of uterine sarcoma was33cases, the rate was58.9%, the diagnosis rate of leiomyosarcoma was lower16/33(48.5%), however compared with the endometrial stromal sarcomas9/12(75%) and malignant mullerian mixed tumor8/11(72.7%); there was not significant different (P>0.05).Conclusion:Though the incidence of uterine sarcoma was low, the prognosis was poor and preoperative diagnosis was difficult because of lack in their specific clinical features. Diagnostic curettage and cervix neoplasm biopsy preoperative was an effective method for diagnosis. Surgical treatment consisting of radical hysterdctomy followed by adjuvant chemotherapy or radiotherapy can decrease the relapse and mortality rate.