Gallup D G, Gable D S, Talledo O E, Otken L B
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912.
Am J Obstet Gynecol. 1989 Sep;161(3):533-8; discussion 538-9. doi: 10.1016/0002-9378(89)90352-9.
From 1972 through 1987, 40 patients at the Medical College of Georgia were assessed with a diagnosis of mixed müllerian tumors which constituted 3.5% of all female genital tract malignancies. The mean patient age was 65.3 years; 60% of the patients had stage I disease. Of those patients with clinical stage I disease, more advanced disease was found at celiotomy in 33%. Retroperitoneal nodes were positive for malignancy in 35% of 20 patients who underwent node sampling. Cell washings were positive in 12%, and 9% had omental metastases. Forty-seven percent had homologous tumors; 53% of tumors were heterologous. Relatively poor prognosis was associated with large tumor volume, vascular invasion, nodal metastases, and disease outside the uterus. The overall survival rate was 32%; 14 of 24 patients with stage I disease are dead of disease. Of patients dead of disease, 92.5% had distant metastases. Adjuvant therapy with a combination of VP-16, cisplatin, and irradiation was beneficial in four high-risk patients.
1972年至1987年期间，佐治亚医学院对40例被诊断为混合性苗勒管肿瘤的患者进行了评估，此类肿瘤占所有女性生殖道恶性肿瘤的3.5%。患者的平均年龄为65.3岁；60%的患者处于I期疾病。在那些临床I期疾病的患者中，33%在剖腹手术时发现有更晚期的疾病。在接受淋巴结取样的20例患者中，35%的腹膜后淋巴结有恶性肿瘤。细胞冲洗液阳性率为12%，9%有网膜转移。47%为同源性肿瘤；53%为异源性肿瘤。预后相对较差与肿瘤体积大、血管侵犯、淋巴结转移以及子宫外疾病有关。总体生存率为32%；24例I期疾病患者中有14例死于该病。在死于该病的患者中，92.5%有远处转移。对于4例高危患者，采用依托泊苷、顺铂和放疗联合的辅助治疗是有益的。
