Gracia Myriam, Yildirim Yusuf, Macuks Ronalds, Mancari Rosanna, Achimas-Cadariu Patriciu, Cusine-Lopez Laura, Novak Zoltan, Dallaku Kastriot, Zapardiel Ignacio
Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.
Tepecik Trainning and Research Hospital, Izmir, Turkey.
Int J Gynaecol Obstet. 2023 Dec;163(3):868-874. doi: 10.1002/ijgo.14998. Epub 2023 Jul 24.
To analyze the impact of perioperative characteristics on the risk of recurrence in patients with uterine leiomyosarcomas.
A sub-analysis of the SARComa of the UTerus (SARCUT) study, which is a multicentric cross-sectional pan-European study that included 390 patients diagnosed with leiomyosarcoma, between 2001 and 2007. Perioperative factors related to risk of recurrence and survival were analyzed.
The 5-year and 10-year disease-free survivals (DFS) were 46% and 55%, respectively. Overall survival at 5 and 10 years was 34% and 47%, respectively. The most important factors related to global recurrence were the incomplete cytoreduction (hazard ratio [HR] 2.87; 95% confidence interval [CI] 1.91-4.31); performing bilateral adnexectomy (HR 2.71; 95% CI 1.23-5.93); tumor persistence after any treatment (HR 2.38; 95% CI 1.39-4.06); and adjuvant chemotherapy administration (HR 2.55; 95% CI 1.82-3.58) or adjuvant radiotherapy (HR 2.26; 95% CI 1.53-3.32). The major factors significantly associated with pelvic relapse were tumor persistence after any treatment (HR 3.63; 95% CI 1.83-7.20) and adjuvant radiotherapy (HR 2.74; 95% CI 1.44-5.20). Incomplete cytoreduction was the most important factor associated with distant relapse (HR 1.91; 95% CI 1.22-2.97). The most important factors related to overall survival were tumor persistence after any treatment (HR 4.59; 95% CI 2.51-8.40), incomplete cytoreduction (HR 3.68; 95% CI 2.44-5.56), tumor margin involvement (HR 2.41; 95% CI 1.64-3.55) and adjuvant chemotherapy (HR 1.91; 95% CI 1.31-2.78).
Complete cytoreduction is the main prognosis factor impacting the DFS and overall survival of patients with uterine leiomyosarcoma. Adjuvant chemotherapy administration was associated with decreased rates of DFS and overall survival. The adjuvant radiotherapy was associated with a higher risk of global recurrence.
分析围手术期特征对子宫平滑肌肉瘤患者复发风险的影响。
对子宫肉瘤（SARCUT）研究进行亚组分析，该研究是一项多中心横断面泛欧洲研究，纳入了2001年至2007年间390例诊断为平滑肌肉瘤的患者。分析与复发风险和生存相关的围手术期因素。
5年和10年无病生存率（DFS）分别为46%和55%。5年和10年总生存率分别为34%和47%。与总体复发相关的最重要因素是细胞减灭术不完全（风险比[HR]2.87；95%置信区间[CI]1.91 - 4.31）；进行双侧附件切除术（HR 2.71；95% CI 1.23 - 5.93）；任何治疗后肿瘤持续存在（HR 2.38；95% CI 1.39 - 4.06）；以及辅助化疗（HR 2.55；95% CI 1.82 - 3.58）或辅助放疗（HR 2.26；95% CI 1.53 - 3.32）。与盆腔复发显著相关的主要因素是任何治疗后肿瘤持续存在（HR 3.63；95% CI 1.83 - 7.20）和辅助放疗（HR 2.74；95% CI 1.44 - 5.20）。细胞减灭术不完全是与远处复发相关的最重要因素（HR 1.91；95% CI 1.22 - 2.97）。与总生存相关的最重要因素是任何治疗后肿瘤持续存在（HR 4.59；95% CI 2.51 - 8.40）、细胞减灭术不完全（HR 3.68；95% CI 2.44 - 5.56）、肿瘤边缘受累（HR 2.41；95% CI 1.64 - 3.55）和辅助化疗（HR 1.91；95% CI 1.31 - 2.78）。
完全细胞减灭术是影响子宫平滑肌肉瘤患者DFS和总生存的主要预后因素。辅助化疗与DFS和总生存率降低相关。辅助放疗与更高的总体复发风险相关。
