Department of Gynecologic Oncology, Malatya Education and Research Hospital, Malatya, Turkey.
Department of Gynecologic Oncology, School of Medicine, Gazi University, Ankara, Turkey.
J Gynecol Oncol. 2019 Jul;30(4):e54. doi: 10.3802/jgo.2019.30.e54. Epub 2019 Feb 4.
In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP).
A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed.
Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349-24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded.
Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.
本研究旨在评估诊断为具有不确定恶性潜能的子宫平滑肌肿瘤（STUMP）患者的临床病理特征、产科和肿瘤学结局。
对 2006 年 1 月至 2017 年 12 月期间接受 upfront 手术治疗的 STUMP 患者进行了一项双机构的数据库回顾性研究。回顾性分析了包括诊断时年龄、复发率、无病生存率、总生存率和生育结局在内的数据。
本研究共纳入 57 例 STUMP 患者。诊断时的中位年龄为 42 岁（范围为 16 至 75 岁）。中位随访时间为 57 个月（范围为 16 至 125 个月）。8 例（14%）患者在随访期间复发。7 例患者复发 STUMP，1 例患者在 14 个月后复发平滑肌肉瘤。7 例复发 STUMP 患者存活，而其余患者死亡。行子宫肌瘤切除术和子宫切除术的患者复发率相似。肿瘤子宫定位（浆膜下、壁内-黏膜下）的存在显著影响复发率（优势比=5.72；95%置信区间=1.349-24.290；p=0.018）。27 例行子宫肌瘤切除术的患者中有 10 人有生育愿望，记录到 7 例妊娠。
我们的研究结果表明，对于 STUMP 患者，保留生育力的方法是可行的，尽管可能会出现复发。
