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子宫恶性苗勒管混合瘤的临床病理分析

Clinicopathologic analysis of uterine malignant mixed müllerian tumors.

作者信息

Nielsen S N, Podratz K C, Scheithauer B W, O'Brien P C

机构信息

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905.

出版信息

Gynecol Oncol. 1989 Sep;34(3):372-8. doi: 10.1016/0090-8258(89)90176-5.

Abstract

A clinicopathologic evaluation of 60 patients (median age, 66 years) presenting for primary treatment of uterine malignant mixed müllerian tumors between 1959 and 1982 was conducted. Surgical stage was utilized for assessment of survival by stage. With a minimum follow-up of 5 years, overall 2- and 5-year Kaplan-Meier survival estimates were 53 and 39%, respectively; they were 75 and 58% when disease was confined to the uterus and 27 and 15% when disease extended beyond the uterus. By log-rank and logit-rank analysis, surgical stage and depth of invasion stratified by stage were significant prognostic determinants; no significant association was found with carcinoma grade, sarcoma mitotic figure count, sarcoma histologic subtype, sarcoma necrosis, or capillary-like space involvement. No significant survival advantage was found for surgery plus irradiation or surgery plus chemotherapy compared with surgery alone after stratification according to stage. Progression-free survival after complete extirpation of macroscopic disease was not significantly different, stage for stage, between surgery alone and surgery plus radiotherapy.

摘要

对1959年至1982年间因子宫恶性混合苗勒管肿瘤初次治疗前来就诊的60例患者(中位年龄66岁)进行了临床病理评估。采用手术分期来评估各期的生存率。在至少5年的随访期后,2年和5年的Kaplan-Meier总生存率估计值分别为53%和39%;当疾病局限于子宫时,2年和5年生存率分别为75%和58%,当疾病超出子宫范围时,2年和5年生存率分别为27%和15%。通过对数秩和对数单位秩分析,手术分期以及按分期分层的浸润深度是显著的预后决定因素;未发现与癌分级、肉瘤有丝分裂计数、肉瘤组织学亚型、肉瘤坏死或毛细血管样间隙受累有显著关联。根据分期分层后,与单纯手术相比,手术加放疗或手术加化疗未发现有显著的生存优势。在肉眼可见的疾病完全切除后,单纯手术与手术加放疗之间的无进展生存期,按分期比较无显著差异。

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