Mactier Karen E, Baxter Mark A, Peters Adam L, Fair Katherine, Hannington Laura, Robertson James, Wood Georgina E, Sarwar Asma, Bishr Mai K, Webb Rebekah, Al-Zubaidi Mohammed, Eastlake Leonie, Lankester Katharine, McInerney Samuel, Creedon Helen, Stillie Alison L, Purshouse Karin
Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK.
BMJ Open. 2024 Dec 26;14(12):e094838. doi: 10.1136/bmjopen-2024-094838.
Although rare, uterine sarcomas account for a high proportion of uterine cancer mortality. Treatment options and robust trial data are limited.
The TOURISM study (Treatment Outcomes in UteRIne SarcoMa) is a UK-wide study by the National Oncology Trainees Collaborative for Healthcare Research which aimed to characterise this patient cohort.
A retrospective descriptive cohort study. Patients with carcinosarcomas/mixed Mullerian tumours, non-uterine gynaecological sarcomas and uterine metastases were excluded. Routine clinical data, including general patient demographics, diagnosis, treatment and outcomes, were collated and pseudonymised.
Patients diagnosed with uterine sarcoma in the UK National Health Service between 1 January 2008 and 31 December 2017 were identified from electronic records.
A total of 406 patients from eight centres were eligible for inclusion.
The median age at diagnosis was 56 years, with leiomyosarcoma the most common diagnosis (54.4%). The majority (57.9%) were diagnosed at the International Federation of Gynecology and Obstetrics stage I, with 19.7% diagnosed at stage IV. Nearly half (45.2%) of the patients received at least one line of chemotherapy, of which most (81.0%) received doxorubicin first-line. In the stage I group 7.4% received adjuvant chemotherapy and 15.0% received adjuvant radiotherapy. Median overall survival was 37 months; however, survival varied significantly by stage at diagnosis (stage I: 105 months; stage II: 33 months; stage III: 19 months; stage IV: 14 months).
Our data highlight the diversity in patient management in uterine sarcoma and a marked survival advantage for patients diagnosed with stage I disease. These data highlight the importance of a multidisciplinary approach and describe real-world trends in systemic therapies, radiotherapy and surgical treatment in this rare cancer type.
子宫肉瘤虽罕见，但在子宫癌死亡率中占比很高。治疗选择和有力的试验数据有限。
TOURISM研究（子宫肉瘤治疗结果研究）是英国国家肿瘤学实习医生医疗保健研究协作组织在全英国范围内开展的一项研究，旨在描述该患者群体的特征。
一项回顾性描述性队列研究。排除癌肉瘤/混合性苗勒管肿瘤、非子宫妇科肉瘤和子宫转移瘤患者。整理包括患者一般人口统计学、诊断、治疗和结局等常规临床数据并进行匿名化处理。
从电子记录中识别出2008年1月1日至2017年12月31日期间在英国国民医疗服务体系中被诊断为子宫肉瘤的患者。
来自八个中心的406名患者符合纳入条件。
诊断时的中位年龄为56岁，平滑肌肉瘤是最常见的诊断类型（54.4%）。大多数（57.9%）在国际妇产科联盟（FIGO）I期被诊断，19.7%在IV期被诊断。近一半（45.2%）的患者接受了至少一线化疗，其中大多数（81.0%）一线接受阿霉素治疗。在I期组中，7.4%接受辅助化疗，15.0%接受辅助放疗。中位总生存期为37个月；然而，生存期因诊断时的分期不同而有显著差异（I期：105个月；II期：33个月；III期：19个月；IV期：14个月）。
我们的数据突出了子宫肉瘤患者管理的多样性以及I期疾病患者显著的生存优势。这些数据强调了多学科方法的重要性，并描述了这种罕见癌症类型在全身治疗、放疗和手术治疗方面的真实世界趋势。
