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中国妇科癌肉瘤患者预后因素的研究 妇科癌肉瘤的预后

A Study of Prognostic Factors of Chinese Patients with Gynecologic Tract Carcinosarcomas Prognosis of Gynecologic Carcinosarcomas.

作者信息

Ye Dan, Shen Hao-Ran, Yao Liangqing

机构信息

Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China.

出版信息

Cancer Manag Res. 2020 Oct 29;12:10781-10788. doi: 10.2147/CMAR.S267128. eCollection 2020.

DOI:10.2147/CMAR.S267128
PMID:33149683
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7605589/
Abstract

BACKGROUND

Thinking of the rarity and malignancy of gynecologic tract carcinosarcomas (GTCS), the aim of the study was to investigate the possible predictors of relapse-free survival (RFS) and overall survival (OS) for GTCS patients.

METHODS

We performed a retrospective cohort study of women with GTCS at our hospital between January 2009 and December 2013. We used the Kaplan-Meier method to calculate RFS and OS, and Cox regression analysis to define the survival effects of risk factors.

RESULTS

A total of 45 GTCS patients were included in the study. The median follow-up time was 46 months. Cox regression analysis showed that lymph node metastasis was significantly associated with worse RFS (HR: 3.145; 95%CI: 1.181-8.378; =0.022) and OS (HR: 4.065; 95%CI: 1.57-10.524; =0.004). Pelvic lymphadenectomy had a favorable RFS (HR: 0.213; 95%CI: 0.057-0.796; = 0.021).

CONCLUSION

Lymph node metastasis significantly affected the prognosis of uterine carcinosarcoma. Pelvic lymphadenectomy could reduce the relapse rate of GTCS patients.

摘要

背景

考虑到妇科癌肉瘤(GTCS)的罕见性和恶性程度,本研究旨在探讨GTCS患者无复发生存期(RFS)和总生存期(OS)的可能预测因素。

方法

我们对2009年1月至2013年12月期间我院收治的GTCS女性患者进行了一项回顾性队列研究。我们使用Kaplan-Meier方法计算RFS和OS,并通过Cox回归分析确定危险因素对生存的影响。

结果

本研究共纳入45例GTCS患者。中位随访时间为46个月。Cox回归分析显示,淋巴结转移与较差的RFS(HR:3.145;95%CI:1.181-8.378;P=0.022)和OS(HR:4.065;95%CI:1.57-10.524;P=0.004)显著相关。盆腔淋巴结清扫术对RFS有良好影响(HR:0.213;95%CI:0.057-0.796;P = 0.021)。

结论

淋巴结转移显著影响子宫癌肉瘤的预后。盆腔淋巴结清扫术可降低GTCS患者的复发率。

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本文引用的文献

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Multimodality adjuvant therapy and survival outcomes in stage I-IV uterine carcinosarcoma.Ⅰ期-Ⅳ期子宫癌肉瘤的多模态辅助治疗与生存结局。
Int J Gynecol Cancer. 2020 Jul;30(7):1012-1017. doi: 10.1136/ijgc-2020-001315. Epub 2020 May 23.
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Prognostic factors impacting survival in early stage uterine carcinosarcoma.影响早期子宫癌肉瘤生存的预后因素。
Gynecol Oncol. 2019 Jan;152(1):31-37. doi: 10.1016/j.ygyno.2018.10.034. Epub 2018 Nov 8.
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Uterine Sarcoma: Analysis of 13,089 Cases Based on Surveillance, Epidemiology, and End Results Database.
子宫肉瘤:基于监测、流行病学和最终结果数据库的13089例病例分析
Int J Gynecol Cancer. 2016 Jul;26(6):1098-104. doi: 10.1097/IGC.0000000000000720.
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Uterine Sarcoma, Version 1.2016: Featured Updates to the NCCN Guidelines.子宫肉瘤临床实践指南(2016 年版)
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Rare uterine cancer: carcinosarcomas. Review from histology to treatment.罕见的子宫体癌:癌肉瘤。从组织学到治疗的综述。
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Gynecologic Cancer InterGroup (GCIG) consensus review for uterine and ovarian carcinosarcoma.妇科肿瘤研究组(GCIG)关于子宫和卵巢癌肉瘤的共识综述。
Int J Gynecol Cancer. 2014 Nov;24(9 Suppl 3):S55-60. doi: 10.1097/IGC.0000000000000228.
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The role of lymphadenectomy in uterine sarcoma: a clinical practical approach based on retrospective analysis.淋巴结切除术在子宫肉瘤中的作用:基于回顾性分析的临床实用方法。
Anticancer Res. 2014 Feb;34(2):985-93.
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[Carcinosarcoma of the ovary treated with paclitaxel and carboplatin chemotherapy - a report of 4 cases].[紫杉醇联合卡铂化疗治疗卵巢癌肉瘤——4例报告]
Gan To Kagaku Ryoho. 2013 Sep;40(9):1249-53.