Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.
J Obstet Gynaecol Res. 2021 Dec;47(12):4357-4364. doi: 10.1111/jog.15013. Epub 2021 Sep 15.
We collected the clinical data of 260 patients admitted to the hospital from April 2003 to September 2019 with pathologically confirmed intravenous leiomyomatosis (IVL) and followed up with these patients regularly. Univariate and multivariate logistic regression analyses were carried out on the relevant recurrence factors.
A total of 166 patients were regularly followed up, the median follow-up time was 36 (range 2-168) months, 14 (5.4%) patients eventually relapsed, and the median recurrence time was 8.5 (range 2-42) months. The univariate analysis showed that age (p = 0.003) and surgical type (p < 0.001) were associated with recurrence, and multivariate regression analysis demonstrated that surgical type was the only factor associated with recurrence (p < 0.001, OR 20.01).
The use of gonadotrophin releasing hormone agonist (GnRHa) cannot reduce the postsurgical recurrence rate of patients with UIVL. Compared to total hysterectomy and bilateral salpingo-oophorectomy (TH-BSO), total hysterectomy (TH) does not increase the odds of recurrence, but the chance of recurrence with tumorectomy (TE) is 20 times higher than that of TH-BSO.
我们收集了 2003 年 4 月至 2019 年 9 月期间因病理证实的静脉内平滑肌瘤病（IVL）入院的 260 例患者的临床资料，并对这些患者进行了定期随访。对相关复发因素进行单因素和多因素逻辑回归分析。
共有 166 例患者定期随访，中位随访时间为 36（范围 2-168）个月，14（5.4%）例患者最终复发，中位复发时间为 8.5（范围 2-42）个月。单因素分析显示，年龄（p=0.003）和手术类型（p<0.001）与复发相关，多因素回归分析显示，手术类型是唯一与复发相关的因素（p<0.001，OR 20.01）。
使用促性腺激素释放激素激动剂（GnRHa）不能降低 UIVL 患者术后复发率。与全子宫切除术和双侧输卵管卵巢切除术（TH-BSO）相比，全子宫切除术（TH）并不会增加复发的几率，但肿瘤切除术（TE）的复发几率是 TH-BSO 的 20 倍。
