Nickie-Psikuta M, Gawrychowski K
Department of Gynaecological Oncology, Maria Słodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
Eur J Gynaecol Oncol. 1993;14 Suppl:105-13.
Three hundred and ten cases of uterine sarcomas, among them, according to pathology: LMS (Leiomyosarcoma)--117, MMS (Mixed mesodermal sarcoma)--62, ESS (Endometrial stromal sarcoma)--56, CS (Carcinosarcoma)--27, RBMS (Rhabdomyosarcoma)--18 and other sarcomas--30, were retrospectively evaluated at the Maria Skłodowska-Curie Memorial Cancer Center between 1950 and 1985. These mesodermal tumors were divided into uterine corpus sarcomas (295) and the rarely occurring uterine cervix sarcomas. As the main modality of treatment 307 patients underwent surgery. Almost all patients received adjuvant radiotherapy but 51 cases of LMS. Overall 5-year survival was 34.5% and in particular subgroups the survivals were as follows: the best, 52% in LMS; lower, 30% in ESS; poor survival about 20% in CS and MMS. In spite of low curability in the majority of subgroups except LMS, the cases of CS with primary site in uterine cervix distinguished itself with better results. No significant survival advantage was found for surgery plus radiotherapy in LMS with low grade mitotic activity, (10 mitoses/10 HPF) compared with surgery alone (63% and 54%). These cases seem to have better prognosis in LMS with high grade mitotic activity (10 mitoses/10 HPF) and do not require adjuvant radiotherapy.
1950年至1985年间,玛丽亚·斯克洛多夫斯卡-居里纪念癌症中心对310例子宫肉瘤患者进行了回顾性评估。根据病理类型,其中平滑肌肉瘤(LMS)117例、混合性中胚层肉瘤(MMS)62例、子宫内膜间质肉瘤(ESS)56例、癌肉瘤(CS)27例、横纹肌肉瘤(RBMS)18例以及其他肉瘤30例。这些中胚层肿瘤分为子宫体肉瘤(295例)和罕见的子宫颈肉瘤。307例患者接受了手术作为主要治疗方式。几乎所有患者都接受了辅助放疗,但51例平滑肌肉瘤患者除外。总体5年生存率为34.5%,各亚组的生存率如下:最好的是平滑肌肉瘤,为52%;较低的是子宫内膜间质肉瘤,为30%;癌肉瘤和混合性中胚层肉瘤的生存率较差,约为20%。尽管除平滑肌肉瘤外的大多数亚组治愈率较低,但原发于子宫颈的癌肉瘤病例结果较好。与单纯手术(63%和54%)相比,有丝分裂活性低(10个有丝分裂/10高倍视野)的平滑肌肉瘤患者接受手术加放疗未发现显著的生存优势。这些有丝分裂活性高(10个有丝分裂/10高倍视野)的平滑肌肉瘤病例似乎预后较好,不需要辅助放疗。