Marth C, Windbichler G, Petru E, Dirschlmayer W, Obermair A, Czerwenka K, Müller-Holzner E, Dapunt O
Department of Obstetrics and Gynecology, University Hospitals Innsbruck, Austria.
Gynecol Oncol. 1997 Jan;64(1):121-5. doi: 10.1006/gyno.1996.4538.
Malignant mixed mesodermal tumors (MMMT) are the most malignant neoplasms known to occur in the uterus. The most important prognostic factors are the extent of tumor at diagnosis, depth of myometrial invasion, and, as regarded by some authors, the sarcomatous component. We report on a retrospective analysis in 83 patients with MMMT. By univariate analysis survival was dependent on stage, depth of myometrial invasion, kind of therapy, age at menopause, and parity. However, the sarcomatous component did not significantly influence survival. Using the multivariate Cox regression analysis stage and parity or depth of myometrial invasion and parity were found to independently predict prognosis. Despite an interval of more than 20 years from the last childbirth to tumor appearance a beneficial influence of parity on the prognosis of MMMT was identified. This is unique in oncology. Especially patients with more than three children formed a subgroup of long-term survivors. It is interesting to note that parity was found by means of a Cox regression analysis to be statistically independent, and no correlation with other classical prognostic factors was detected.
恶性混合性中胚叶肿瘤（MMMT）是已知发生于子宫的最恶性肿瘤。最重要的预后因素是诊断时肿瘤的范围、肌层浸润深度，以及一些作者认为的肉瘤成分。我们报告了对83例MMMT患者的回顾性分析。单因素分析显示，生存率取决于分期、肌层浸润深度、治疗方式、绝经年龄和产次。然而，肉瘤成分对生存率没有显著影响。使用多变量Cox回归分析发现，分期和产次或肌层浸润深度和产次可独立预测预后。尽管从最后一次分娩到肿瘤出现的间隔超过20年，但仍发现产次对MMMT的预后有有益影响。这在肿瘤学中是独一无二的。尤其是有三个以上孩子的患者形成了一个长期存活者亚组。有趣的是，通过Cox回归分析发现产次在统计学上是独立的，且未检测到与其他经典预后因素的相关性。
