Kokawa K, Nishiyama K, Ikeuchi M, Ihara Y, Akamatsu N, Enomoto T, Ishiko O, Motoyama S, Fujii S, Umesaki N
Department of Obstetrics and Gynecology, Wakayama Medical University, 811-1 kimiidera, Wakayama 641-0012, Japan.
Int J Gynecol Cancer. 2006 May-Jun;16(3):1358-63. doi: 10.1111/j.1525-1438.2006.00536.x.
To review clinical outcomes and therapeutic varieties, we were invited to submit data from the patients who were treated for uterine sarcomas in Japan from 1990 to 2003. Uterine sarcomas were defined as leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), and carcinosarcoma (CS). Of a total of 97 patients, 36 (37.1%) were diagnosed with LMS of the uterine corpus, 15 (15.5%) with ESS, 46 (47.4%) with CS. Median age at diagnosis was 59 (21-85) years. Clinical stages based on FIGO were 41 (42.3%) with stage I disease, 6 (6.2%) with staged II, 34 (35.1%) with stage III, and 16 (16.5%) with stage IV. The median follow-up period for all patients was 13 (1-108) months and median disease-free period was 9 (0-96) months. The 1-year survival rate and disease-free survival (DFS) rate were calculated in patients with all sarcomas (overall survival [OAS], 61.3%; DFS, 46.6%). Statistical analysis showed that younger age (less than 50 years), early stage (stages I and II), and surgical procedure (extended hysterectomy [EH] and radical hysterectomy [RH]) were associated with significantly better OAS. Histologic types did not affect the survival period. In conclusion, aggressive surgery including EH or RH at the time of initial operation offers the possibility of prolonged survival.
为了回顾临床结果和治疗方法,我们受邀提交1990年至2003年在日本接受子宫肉瘤治疗的患者的数据。子宫肉瘤被定义为平滑肌肉瘤(LMS)、子宫内膜间质肉瘤(ESS)和癌肉瘤(CS)。在总共97例患者中,36例(37.1%)被诊断为子宫体平滑肌肉瘤,15例(15.5%)为子宫内膜间质肉瘤,46例(47.4%)为癌肉瘤。诊断时的中位年龄为59岁(21 - 85岁)。根据国际妇产科联盟(FIGO)的临床分期,I期疾病患者有41例(42.3%),II期有6例(6.2%),III期有34例(35.1%),IV期有16例(16.5%)。所有患者的中位随访期为13个月(1 - 108个月),中位无病期为9个月(0 - 96个月)。计算了所有肉瘤患者的1年生存率和无病生存率(DFS)(总生存率[OAS],61.3%;DFS,46.6%)。统计分析表明,年龄较轻(小于50岁)、早期阶段(I期和II期)以及手术方式(扩大子宫切除术[EH]和根治性子宫切除术[RH])与显著更好的总生存率相关。组织学类型不影响生存期。总之,初次手术时进行包括EH或RH在内的积极手术有可能延长生存期。