| Objective: To study the clinical features,treatment methods and prognosis of different histological types of uterine sarcoma,to understand the progress of the disease,to evaluate the therapeutic effects,and to guide the clinical practice.Method: A retrorespective descriptive analysis in the clinical features,diagnosis,treatment and prognosis was done for 35 cases of uterine sarcoma from January 2000 to December 2010 hospitalized in The First Affiliated Hospital of Guangxi Medical University.Analyse the correlation of the influence factors of uterine sarcoma and compare living condition.Results:(1)1.Clinical features: the average age of onset was41.40±11.78 years(21~75 years).The average number of pregnancies was3.51±2.11 times,and the average number of births was 1.94±1.43 times.A total of 31.43% of the patients were postmenopausal.The age of primary tide was13.94±1.92 years old,with a period of 5.79±1.59 days,and a menstrual cycle of30.23±4.50 days.6 of the 35 cases were treated for uterine leiomyoma and 1 had undergone hysteroscopic endometrial polyps.(2)Initial clinical manifestations:54.29% were irregular vaginal bleeding,22.86% were abdominal distension and/or abdominal pain,11.43% were pelvic mass,5.71% were vaginal discharge or abnormal secretion,and 5.71% were pelvic compressionsymptoms.(3)Auxiliary examination: 32 routine preoperative ultrasonography,16 patients showed abundant blood flow,and the average RI of 16 patients was0.57,of which 12 patients were greater than 0.5.In 8 patients,CT and MRI were performed before operation,and the lesion location,size and surrounding tissue relationship were more accurate than that of ultrasonography.10 of the cases has increasing level of CA125.19 cases had preoperative pathological examinations and 11 cases were indicated as uterine sarcoma.(4)Diagnosis: the preoperative diagnosis rate was 37.14%.29 cases were staged,The number of each period were 23,2,1,4,and 4 cases hadn't be staged.The number of LGESS,HGESS,UUS,uLMS and AS are 17,5,2,8 and 3.(5)Treatment: 32 patients underwent surgical treatment,and the surgical method was: 1 of them had hysteromyomectomy,and 8 patients only had total hysterectomy and adnexectomy.21 cases also had lymphadenectomy.In addition to the total hysterectomy and lymph node dissection,6 cases had omentum major resection.9 cases had postoperative chemotherapy,and 6 of them had postoperative radiotherapy,and endocrine therapy were performed in 6 cases.(6)Follow-up:the overall survival rates of 23 patients with uterine sarcoma were 94.74%,84.21%,78.20% and 64.51%,respectively,in patients with uterine sarcoma for 1year,2 years,3 years and 5 years.A total of 12 cases were lost.Pathological classification and CA125 were the factors influencing survival results.Conclusions:(1)In uterine sarcoma,the mean onset age of LGESS was lower than that of UUS.LGESS patients had more average pregnancies than uLMS and AS patients.LGESS and AS patients,on average,produced more,and the average menstrual period was longer.(2)The most common initial symptom of uterine sarcoma is irregular vaginal bleeding,followed by abdominal pain,abdominal distension and abdominal mass.(3)The preferred imagingexamination for uterine sarcoma is ultrasound doppler,and the blood flow resistance index(RI)can be used as an auxiliary diagnostic index.CT and MRI combined with ultrasound can improve the diagnosis rate.Lack of specific tumor markers in uterine sarcoma;Preoperative segmental diagnosis and biopsy can improve preoperative diagnosis rate.(4)The diagnosis rate of uterine sarcoma is low before operation,which is easily misdiagnosed as uterine leiomyoma.(5)The preferred treatment for uterine sarcoma is surgical treatment,adjuvant chemotherapy,radiotherapy and endocrine therapy can reduce tumor recurrence.(6)Pathological type is an independent factor affecting the prognosis of uterine sarcoma. |
PDF Full Text Request