Yuan Hua, Wang Tonghui, Li Ning, Yao Hongwen
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, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, China.
Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
World J Surg Oncol. 2024 Dec 5;22(1):325. doi: 10.1186/s12957-024-03610-3.
To investigate the clinicopathological characteristics and prognosis of patients with undifferentiated uterine sarcomas (UUS).
29 patients with UUS who were treated at our institution between 2001 and 2020 were analyzed.
The median age at diagnosis was 52 years (range: 26-70 years). The FIGO 2009 distribution by stage was as follows: stage I, 17 patients (58.6%); stage II, 5 patients (17.2%); stage III, 4 patients (13.8%); and stage IV, 3 patients (10.3%). For 28 patients who underwent surgical treatment, 27 patients (96.4%) underwent total/sub-radical/radical hysterectomy combined bilateral salpingo-oophorectomy, 17 (58.6%) pelvic lymphadenectomy, 7 (24.1%) para-aortic lymphadenectomy and 8 (28.6%) patients underwent omentectomy, as part of the initial surgical treatment. The median follow-up was 23.4 months (range: 4.5-200.2 months). 18 patients (62.1%) died during follow up, and 13 patients (72.2%, 13/18) died within 2 years after diagnosis. Median progression-free survival (mPFS) and overall survival (mOS) for the entire cohort were 15.5 and 27.4 months, respectively. 2-year and 5-year PFS were 40.3% and 26.9%. 2-year and 5-year OS were 54.0% and 36.5%. Stage-specific median PFS and OS were as follows: stage I-II-17.7 and 35.5 months, stage III-IV-6.0 and 6.7 months. Patients with recurrent UUS who underwent cytoreduction surgery associated with an improved overall survival (mOS: 52.9 vs. 17.9 months), but the difference was not statistically significant (P = 0.081).
UUS are a rare group of tumors with an aggressive behavior and poor outcomes. A majority rapidly develops distant metastases despite surgical resection.
探讨未分化子宫肉瘤（UUS）患者的临床病理特征及预后。
分析2001年至2020年在本机构接受治疗的29例UUS患者。
诊断时的中位年龄为52岁（范围：26 - 70岁）。按照2009年国际妇产科联盟（FIGO）分期分布如下：I期，17例患者（58.6%）；II期，5例患者（17.2%）；III期，4例患者（13.8%）；IV期，3例患者（10.3%）。对于28例行手术治疗的患者，27例（96.4%）接受了全子宫/次根治性/根治性子宫切除术联合双侧输卵管卵巢切除术，17例（58.6%）接受了盆腔淋巴结清扫术，7例（24.1%）接受了腹主动脉旁淋巴结清扫术，8例（28.6%）患者接受了大网膜切除术，作为初始手术治疗的一部分。中位随访时间为23.4个月（范围：4.5 - 200.2个月）。18例患者（62.1%）在随访期间死亡，13例患者（72.2%，13/18）在诊断后2年内死亡。整个队列的中位无进展生存期（mPFS）和总生存期（mOS）分别为15.5个月和27.4个月。2年和5年的无进展生存率分别为40.3%和26.9%。2年和5年的总生存率分别为54.0%和36.5%。各分期的中位无进展生存期和总生存期如下：I - II期为17.7个月和35.5个月，III - IV期为6.0个月和6.7个月。接受减瘤手术的复发性UUS患者的总生存期有所改善（mOS：52.9个月对17.9个月），但差异无统计学意义（P = 0.081）。
UUS是一组罕见的肿瘤，具有侵袭性且预后不良。尽管进行了手术切除，大多数患者仍会迅速发生远处转移。
