Park Soo Jin, Kim Junhwan, Kim Jae-Weon, Kim Hee Seung, Yim Ga Won
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2022 Jul;65(4):355-367. doi: 10.5468/ogs.22071. Epub 2022 Jun 27.
This study aims to evaluate the safety and feasibility of laterally extended endopelvic resection (LEER) for sarcoma in the female genital tract.
We prospectively recruited gynecologic cancer patients with sarcoma arising from female genital tract who underwent LEER at Seoul National University Hospital from December 2016 to March 2021. Clinicopathologic characteristics, surgical outcomes including postoperative complications and pain control, and survival outcomes of the patients were investigated.
A total of nine patients were registered for this study. The median age was 56 years. Carcinosarcoma (n=2, 22%), leiomyosarcoma (n=2, 22%), and undifferentiated uterine sarcoma (n=2, 22%) were common histology types. Complete resection was achieved in 88.9%. The most common location of pelvic sidewall tumors was infra-iliac acetabulum (66.7%). The pathologic outcome showed a median tumor size of 9.0 cm and internal iliac vessel resection with pelvic sidewall muscle was performed in all patients. The median estimated blood loss was 1,600 mL (range, 300-22,300), and the patients were postoperatively admitted to the intensive care unit for median 1 day (range, 0-8). Complete response was observed in 44.4% (4/9) in radiologic studies after LEER, and median progression-free survival, treatment-related survival, and overall survival were 3.3, 19.6, and 98.9 months, respectively.
LEER was feasible and safe in treating recurrent sarcoma presenting pelvic sidewall invasion with acceptable survival outcomes and manageable postoperative complications.
本研究旨在评估侧方扩大盆腔脏器切除术（LEER）治疗女性生殖道肉瘤的安全性和可行性。
我们前瞻性招募了2016年12月至2021年3月在首尔国立大学医院接受LEER的女性生殖道肉瘤的妇科癌症患者。研究了患者的临床病理特征、手术结果（包括术后并发症和疼痛控制）以及生存结果。
本研究共纳入9例患者。中位年龄为56岁。常见的组织学类型为癌肉瘤（n = 2，22%）、平滑肌肉瘤（n = 2，22%）和未分化子宫肉瘤（n = 2，22%）。88.9%的患者实现了完全切除。盆腔侧壁肿瘤最常见的位置是髂下髋臼（66.7%）。病理结果显示肿瘤中位大小为9.0 cm，所有患者均进行了髂内血管切除及盆腔侧壁肌肉切除。估计中位失血量为1600 mL（范围300 - 22300），患者术后在重症监护病房的中位住院时间为1天（范围0 - 8）。LEER后影像学研究中44.4%（4/9）的患者观察到完全缓解，中位无进展生存期、治疗相关生存期和总生存期分别为3.3个月、19.6个月和98.9个月。
LEER治疗出现盆腔侧壁侵犯的复发性肉瘤是可行且安全的，生存结果可接受，术后并发症可控。
