Yuan Hua, Wang Tonghui
Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Clinical Lab, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
Gynecol Oncol Rep. 2022 Dec 13;44:101122. doi: 10.1016/j.gore.2022.101122. eCollection 2022 Dec.
To investigate the clinical characteristics and prognosis of primary vaginal sarcoma.
A retrospective analysis of patients with primary vaginal sarcoma treated at our center from 2000 to 2020 was conducted.
Fifteen patients were identified, among which 9 (60.0 %) patients had leiomyosarcoma, 2 (13.3 %) patients had Ewing's sarcoma, 2 (13.3 %) patients had rhabdomyosarcoma, 1 (6.7 %) patient had undifferentiated sarcoma, and 1 (6.7 %) patient had malignant peripheral schwannoma. Nine patients presented with vaginal mass that was the most common primary symptoms. Eleven patients received their primary surgery, and 7 of them received postoperative adjuvant chemotherapy or radiation therapy. The remaining 4 patients received initial chemotherapy and/or radiotherapy because of advanced stage. The distribution by stage was as follows: stage I in 10 patients, stage II in 1 patient, stage III in 2 patients and stage IV in 2 patients. The median follow-up was 43.7 months (10.1-137.5 months). Thirteen patients (86.7 %) had disease extent during follow-up, and among them, 11 patients (11/13, 84.6 %) developed local relapse or adjacent organ metastases, 1 patient (1/13, 7.7 %) developed liver metastases, and the remaining 1 patient (1/13, 7.7 %) developed lung metastases and local relapse during follow-up. Ten (10/13, 76.9 %) patients relapsed within 2 years after diagnosis. Eight patients (8/11, 72.7 %) with local recurrence or adjacent organ metastases received a secondary surgery treatment, and only 2 of them relapsed again. Two-year overall survival (OS) and 5-year OS were 80.0 % and 66.7 %, respectively. Patients with leiomyosarcoma had a tendency toward a better 5-year OS than those with other sarcomas (74.1 % vs 66.7 %, = 0.307).
Primary vaginal sarcomas are aggressive neoplasms with different presenting characteristics. Surgery is the main treatment for primary vaginal sarcoma and for local relapse vaginal sarcoma.
探讨原发性阴道肉瘤的临床特征及预后。
对2000年至2020年在本中心接受治疗的原发性阴道肉瘤患者进行回顾性分析。
共纳入15例患者，其中平滑肌肉瘤9例（60.0%），尤因肉瘤2例（13.3%），横纹肌肉瘤2例（13.3%），未分化肉瘤1例（6.7%），恶性外周神经鞘瘤1例（6.7%）。9例患者以阴道肿物为最常见的主要症状。11例患者接受了初次手术，其中7例接受了术后辅助化疗或放疗。其余4例患者因疾病晚期接受了初始化疗和/或放疗。分期分布如下：Ⅰ期10例，Ⅱ期1例，Ⅲ期2例，Ⅳ期2例。中位随访时间为43.7个月（10.1 - 137.5个月）。13例患者（86.7%）在随访期间出现疾病进展，其中11例患者（11/13，84.6%）发生局部复发或邻近器官转移，1例患者（1/13，7.7%）发生肝转移，其余1例患者（1/13，7.7%）在随访期间发生肺转移和局部复发。10例患者（10/13，76.9%）在诊断后2年内复发。8例局部复发或邻近器官转移的患者（8/11，72.7%）接受了二次手术治疗，其中仅2例再次复发。2年总生存率（OS）和5年OS分别为80.0%和66.7%。平滑肌肉瘤患者的5年OS有优于其他肉瘤患者的趋势（74.1%对66.7%，P = 0.307）。
原发性阴道肉瘤是具有不同表现特征的侵袭性肿瘤。手术是原发性阴道肉瘤及局部复发性阴道肉瘤的主要治疗方法。
