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子宫癌肉瘤与子宫内膜浆液性和透明细胞癌：生存的系统评价和荟萃分析。

Uterine carcinosarcoma vs endometrial serous and clear cell carcinoma: A systematic review and meta-analysis of survival.

机构信息

Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy.

Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy.

出版信息

Int J Gynaecol Obstet. 2022 Sep;158(3):520-527. doi: 10.1002/ijgo.14033. Epub 2021 Dec 11.

DOI:10.1002/ijgo.14033
PMID:34797919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9543416/
Abstract

BACKGROUND

It is unclear whether uterine carcinosarcoma (UCS) is more aggressive than endometrial serous carcinoma (SC) and clear cell carcinoma (CCC).

OBJECTIVES

To compare the prognosis of UCS to that of endometrial SC and CCC, through a systematic review and meta-analysis.

METHODS

Four electronic databases were searched from January 2000 to October 2020. All studies assessing hazard ratio (HR) for death in UCS vs SC and/or CCC. HRs for death with 95% confidence interval were extracted and pooled by using a random-effect model. A significant P-value <0.05 was adopted.

RESULTS

Six studies with 11 029 patients (4995 with UCS, 4634 with SC, 1346 with CCC and 54 with either SC or CCC) were included. UCS showed a significantly worse prognosis than SC/CCC both overall (HR = 1.51; P = 0.008) and at early stage (HR = 1.58; P < 0.001). Similar results were found for UCS vs SC (HR = 1.53; P < 0.001) and UCS vs CCC (HR = 1.60; P < 0.001).

CONCLUSIONS

Compared to SC and CCC, UCS has a significantly worse prognosis, with a 1.5-1.6-fold increased risk of death. This might justify a more aggressive treatment for UCS compared to SC and CCC. Further studies are necessary to define the prognostic impact of different molecular subgroups.

摘要

背景

子宫癌肉瘤（UCS）是否比子宫内膜浆液性癌（SC）和透明细胞癌（CCC）更具侵袭性尚不清楚。

目的

通过系统评价和荟萃分析比较 UCS 与子宫内膜 SC 和 CCC 的预后。

方法

从 2000 年 1 月至 2020 年 10 月，检索了 4 个电子数据库。所有评估 UCS 与 SC 和/或 CCC 死亡风险比（HR）的研究均纳入分析。使用随机效应模型提取并汇总死亡的 HR 及其 95%置信区间。采用 P 值<0.05 为差异有统计学意义。

结果

纳入 6 项研究共 11029 例患者（4995 例 UCS、4634 例 SC、1346 例 CCC 和 54 例 SC 或 CCC）。UCS 的总生存（HR=1.51，P=0.008）和早期生存（HR=1.58，P<0.001）均明显差于 SC/CCC。UCS 与 SC（HR=1.53，P<0.001）和 UCS 与 CCC（HR=1.60，P<0.001）也存在相似的结果。

结论

与 SC 和 CCC 相比，UCS 的预后明显更差，死亡风险增加 1.5-1.6 倍。这可能证明与 SC 和 CCC 相比，UCS 更需要采用积极的治疗方法。需要进一步研究来确定不同分子亚组的预后影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/723becac6ddb/IJGO-158-520-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/7fd3aae629bd/IJGO-158-520-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/47a6c250a3e7/IJGO-158-520-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/8019b33b1395/IJGO-158-520-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/d790bd65f996/IJGO-158-520-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/723becac6ddb/IJGO-158-520-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/7fd3aae629bd/IJGO-158-520-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/47a6c250a3e7/IJGO-158-520-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/8019b33b1395/IJGO-158-520-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/d790bd65f996/IJGO-158-520-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a5/9543416/723becac6ddb/IJGO-158-520-g005.jpg

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