Analysis Of Clinical Features And Prognostic Factors In125 Patients With Uterine Sarcoma

Objective: Explore the Uterine sarcoma(US)clinical characteristics and the related prognostic factors.Methods: Data of US patients in department of gynaecology,the third affiliated hospital of xinjiang medical university from January 2010 to January2017 were collected,and descriptive statistics were conducted on clinical characteristics and correlation analysis of prognosis.Results:(1)In all 125 cases,89(71.2%)were aged?50 years,and 36(28.8%)were aged>50 years.91 cases(72.8%)were premenopausal and 34 cases(27.2%)were menopausal.Among the clinical manifestations,60 cases(48.0%)were irregular vaginal bleeding,18 cases(14.4%)were abdominal pain,17 cases(13.6%)were abdominal mass,and 30 cases(24.0%)were asymptomatic physical examination found.(2)The coincidence rates of preoperative b-ultrasound,CT and MRI were 16.0%,34.3% and 46.4%,respectively.Hysteroscopy was performed in 29 patients before surgery,and 19(65.51%)patients indicated malignancy,among which 15(86.67%)ESS patients indicated maligna-ncy.(3)Postoperative status: 71 cases(56.8%)of stage I patients were diagnosed by FIGO staging and ESS patients were more common,stage II were 14 cases(11.2%),stage III were 25 cases(20.0%),and stage IV were 15 cases(12.0%).In 106 cases(84.84%),the tumor diameter was greater than 5cm.Lymph node resection was performed in 78 patients,and a total of 17 cases(21.8%)indicated positive lymph node metastasis.12cases(25.5%)patients with uLMS,5(18.5%)patients with ESS,uterine glands sarcoma(uterine adenosarcoma,AS)patients not prompted to lymph node metastasis;Oophorectomy was performed in 75 cases(60.0%)and ovarian metastasis in 7cases(9.3%).Among them,39 patients with uLMS had 2 cases of metastasis(5.1%),30 patients with ESS had 5 cases of metastasis(16.7%),and no metastasis(0%)in 10 AS patients.(4)prognosis: the 5-year survival rate of US patients was 68.3%,among which,AS patients(70.0%),LGESS patients(55.6%),uLMS patients(49.2%),and HGESSpatients(43.1%).univariate analysis,the patient's age(P=0.014),preoperative CA125 >35(P=0.023),lymph node metastasis(P=0.000),FIGO stage(P=0.000),maximum tumor diameter(P=0.000),and pathological type(P=0.000)were the associated factors affecting the survival time of patients with US.Cox multivariate analysis showed that high FIGO stage(OR=2.433,95%ci 1.104-5.360,P=0.018),maximum tumor diameter(OR=1.242,95%ci 1.007-1.532,P=0.016),and pathological type(OR=2.157,95%ci 1.582-3.179,P=0.000)were independent factors affecting the prognosis of uterine sarcoma.Conclusions: Aged ? 50 years menstruating and uterine fibroids with tumor diameter exceed 5cm should be highly regarded,preoperative MRI and hysteroscopy should be used to exclude the possibility of malignancy.The high FIGO stage,the largest tumor diameter and the pathological type were independent factors affecting the prognosis of uterine sarcoma.